ABSTRACT
Clinical staging of lung cancer helps to determine the extent of disease and stratify patients into similar prognostic and therapeutic categories. For lung cancer patients an important goal is to separate patients with potential resectable disease from those who are unresectable.1,2 The most recent staging system for lung cancer was published in 1997 (Table 5.1; Figs 5.1-5.5), replacing the 1986 classification,3 and was subjected to detailed discussion at an international symposium in December 1999.4 Suggestions for improvements have also been presented5,6 with special focus on stage IA in the study by Patz et al.7,8
Also in 2000, the International Staging System for Lung Cancer has been validated by studies from Italy including 1296 consecutive patients from a single institution, and from the Netherlands with 2361 patients, who underwent pulmonary resection for non-small cell lung cancer stages I, II, and IIIa.9,10
Overall, the authors conclude that the TNM (tumor, nodes, metastases) staging system accurately reflects the prognosis in primary non-small cell lung cancer. In the Dutch study, no significant difference in survival was demonstrated between patients with stage IB or IIA.
