IASLC 第 9 版肺癌 TNM 分类的验证：重点关注 N 分期。

Validation of IASLC 9th edition TNM classification for lung cancer: focus on N descriptor.

机构信息

Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea.

出版信息

BMC Cancer. 2024 Nov 27;24(1):1460. doi: 10.1186/s12885-024-13139-z.

DOI:10.1186/s12885-024-13139-z

PMID:39604857

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11603870/

Abstract

BACKGROUND

We externally validated the proposed 9th edition of the TNM staging classification with our institution's prospectively collected data and compared it to the 8th edition for overall survival (OS) and freedom from recurrence (FFR).

METHODS

A retrospective analysis was conducted of 4029 cases of stage I-III non-small cell lung cancer that underwent surgical treatment from January 2004 to December 2020. Survival was compared using Kaplan-Meier curves and multivariable Cox regression analysis. The concordance index (C-index), Alkaike information criterion (AIC), and R were used to assess the discriminatory ability.

RESULTS

In the 9th edition, the N2 category (n = 352) was subdivided into N2a (n = 256, 72.7%) and N2b (n = 96, 27.3%). The TNM stage changes were as follows: (1) IIB to IIA, 151 cases (26.0%); (2) IIIA to IIB, 52 cases (11.5%); (3) IIIB to IIIA, 57 cases (61.3%); (4) IIIA to IIIB, 56 cases (12.4%). The survival curves of the proposed 9th edition demonstrated similar patterns to those of the 8th edition, but with a greater discriminative ability for OS and FFR. Subdividing N2 into N2a and N2b refined prognosis prediction. The C-index, AIC, and R2 demonstrated improved values in the proposed 9th edition compared to the 8th edition.

CONCLUSIONS

The proposed 9th edition of the TNM staging classification for lung cancer showed favorable prognostic validity and better discrimination ability than the 8th edition.

摘要

背景

我们使用机构前瞻性收集的数据对第 9 版 TNM 分期分类进行了外部验证，并将其与第 8 版的总生存率 (OS) 和无复发生存率 (FFR) 进行了比较。

方法

对 2004 年 1 月至 2020 年 12 月接受手术治疗的 4029 例 I-III 期非小细胞肺癌病例进行回顾性分析。使用 Kaplan-Meier 曲线和多变量 Cox 回归分析比较生存情况。使用一致性指数 (C-index)、赤池信息量准则 (AIC) 和 R 评估判别能力。

结果

在第 9 版中，N2 期 (n=352) 分为 N2a (n=256，72.7%) 和 N2b (n=96，27.3%)。TNM 分期变化如下：(1) IIB 期至 IIA 期，151 例 (26.0%)；(2) IIIA 期至 IIB 期，52 例 (11.5%)；(3) IIIB 期至 IIIA 期，57 例 (61.3%)；(4) IIIA 期至 IIIB 期，56 例 (12.4%)。第 9 版提出的生存曲线与第 8 版相似，但 OS 和 FFR 的判别能力更强。将 N2 分为 N2a 和 N2b 可进一步预测预后。与第 8 版相比，第 9 版的 C-index、AIC 和 R2 值有所提高。