Erdoğu Volkan, Çıtak Necati, Sezen Celal Buğra, Aksoy Yunus, Aker Cemal, Doğru Mustafa Vedat, Emetli Ece Yasemin, Onay Selin, Saydam Özkan, Metin Muzaffer
Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye.
Department of Thoracic Surgery, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2022 Jul 29;30(3):395-403. doi: 10.5606/tgkdc.dergisi.2022.20089. eCollection 2022 Jul.
In this study, we aimed to evaluate the effects of the transition from the 6 edition of the Tumor, Node, Metastasis (TNM) staging system to the 7 edition, and from the 7 edition to the 8 edition by comparing the stage migrations. We also aimed to externally validate the 8 edition of the TNM staging system.
Between September 2005 and June 2015, a total of 1,077 patients (986 males, 91 females; mean age: 59.6±8.3 years; range, 35 to 84 years) with non-small cell lung cancer who underwent lung resection were retrospectively analyzed. We re-staged patients according to 6, 7, and 8 TNM staging and compared the stage migrations of cases among the three staging systems.
Stage migration in the transition to the 7 edition of the TNM staging system was observed in 368 (34.1%) patients whereas it was observed in 541 (50.2%) patients in the transition to the 8 edition (p<0.001). The rate of upstaging in transition to the 7 edition staging system was 50.2% (n=185), whereas it was 98.1% (n=531) for the transition to the 8 edition (p<0.001). The survival rates of Stages 1B, 2B and 3A increased with transition to the 7 edition and the survival rates of Stages 1B, 2A, 2B, 3A, and 3B increased with the transition to the 8 edition. The best stratification in the survival curves in the 6th edition was between 1B-1A and 3B-3A. In the 7 edition, it occurred between 1B-1A, 3A-2B and 3B-3A and, in the 8 edition, between 1B-1A and 3B-3A.
Stratification according to the 7 edition showed better prognostic validity compared to the 6 edition; and that of the 8 edition was better compared to the 7 edition.
在本研究中，我们旨在通过比较分期迁移来评估从第6版肿瘤、淋巴结、转移（TNM）分期系统向第7版，以及从第7版向第8版转变的影响。我们还旨在对第8版TNM分期系统进行外部验证。
2005年9月至2015年6月期间，对1077例接受肺切除术的非小细胞肺癌患者（986例男性，91例女性；平均年龄：59.6±8.3岁；范围35至84岁）进行回顾性分析。我们根据第6、7和8版TNM分期对患者重新分期，并比较三个分期系统中病例的分期迁移情况。
在向第7版TNM分期系统转变过程中，368例（34.1%）患者出现分期迁移，而在向第8版转变过程中，541例（50.2%）患者出现分期迁移（p<0.001）。向第7版分期系统转变时的分期上调率为50.2%（n=185），而向第8版转变时为98.1%（n=531）（p<0.001）。1B期、2B期和3A期的生存率随着向第7版的转变而提高，1B期、2A期、2B期、3A期和3B期的生存率随着向第8版的转变而提高。第6版生存曲线中最佳分层位于1B-1A和3B-3A之间。在第7版中，分层位于1B-1A、3A-2B和3B-3A之间，在第8版中，分层位于1B-1A和3B-3A之间。
与第6版相比，第7版的分层显示出更好的预后有效性；与第7版相比，第8版的分层更好。
