Wang Jia, Wu Nan, Zheng Qingfeng, Feng Yuan, Yan Shi, Lv Chao, Li Shaolei, Wang Yuzhao, Yang Yue
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, No. 52, Fucheng Avenue, Haidian District, Beijing, 100142, People's Republic of China.
J Cancer Res Clin Oncol. 2014 Jul;140(7):1189-95. doi: 10.1007/s00432-014-1636-0. Epub 2014 Mar 28.
To assess the utilities and drawbacks of the 7th edition of the TNM classification for lung cancer.
Subjects included 1,469 patients who underwent pulmonary resection for primary non-small cell lung cancer. Survival characteristics were compared using the 6th and 7th editions of the staging system.
According to the 6th and 7th editions, respectively, the 5-year survival rates based on stages were as follows: pStage IA (81.0, 81.0 %), pStage IB (70.6, 72.0 %), pStage IIA (61.3, 59.7 %), pStage IIB (56.6, 47.2 %), pStage IIIA (43.4, 37.6 %), pStage IIIB (8.9, 14.9 %), and pStage IV (14.0, 8.0 %). According to the 6th edition, there was no significant difference between pStages IB and IIA (P = 0.268), or between pStages IIA and IIB (P = 0.622), or between pStages IIIB and IV (P = 0.737). According to the 7th edition, there were significant differences between each adjacent stage group, except between pStages IIIB and IV (P = 0.424). According to the 7th edition staging system, 5-year survival rates by T classification were as follows: pT1a, 81.6 %; pT1b, 75.9 %; pT2a, 60.1 %; pT2b, 44.7 %; pT3, 24.4 %; and pT4, 13.2 %; with significant differences between each adjacent pT classification. The 5-year survival rates by M classification were as follows: M0, 57.2 %, M1a, 9.1 %, M1b, 0 %, with a significant difference between M0 and M1a, but there was no significant difference between M1a and M1b.
The UICC 7th edition staging system is considered valid for non-small cell lung cancer patients and appears to be superior in defining different prognostic groups than the 6th edition.
评估肺癌TNM分期第7版的实用性和不足之处。
研究对象包括1469例行原发性非小细胞肺癌肺切除术的患者。使用第6版和第7版分期系统比较生存特征。
根据第6版和第7版，各分期的5年生存率分别如下：pIA期（81.0%，81.0%），pIB期（70.6%，72.0%），pIIA期（61.3%，59.7%），pIIB期（56.6%，47.2%），pIIIA期（43.4%，37.6%），pIIIB期（8.9%，14.9%），pIV期（14.0%，8.0%）。根据第6版，pIB期和pIIA期之间（P = 0.268）、pIIA期和pIIB期之间（P = 0.622）、pIIIB期和pIV期之间（P = 0.737）无显著差异。根据第7版，除pIIIB期和pIV期之间（P = 0.424）外，各相邻分期组之间均有显著差异。根据第7版分期系统，按T分类的5年生存率如下：pT1a期，81.6%；pT1b期，75.9%；pT2a期，60.1%；pT2b期，44.7%；pT3期，24.4%；pT4期，13.2%；各相邻pT分类之间有显著差异。按M分类的5年生存率如下：M0期，57.2%，M1a期，9.1%，M1b期，0%；M0和M1a之间有显著差异，但M1a和M1b之间无显著差异。
国际抗癌联盟（UICC）第7版分期系统被认为对非小细胞肺癌患者有效，且在定义不同预后组方面似乎优于第6版。
