A set of internationally recognized guidelines for staging lung cancer has been revised to more accurately reflect the prognosis of patients with non-small cell lung cancer.
An article in the July issue of Chest reviews the development and final recommendations of the International Staging Committee of the International Association for the Study of Lung Cancer (IASLC) for the staging of non-small cell lung cancer (Chest, July 2009, Vol. 136:1, pp. 1260-1271).
The new staging system, discussed in detail in a June article on AuntMinnie.com, is based on data from more than 100,000 patients at 45 facilities and in 20 countries, enabling researchers to discern far more details and differences in patients' conditions than in the previous system, the committee said in a statement on Tuesday.
Combined with extensive analysis and internal and external validation, the data have led to a system that is more complex, but also more accurate in describing the extent of the cancer, the location and spread of the tumor, and the prognosis for patient subgroups, according to the IASLC.
The new staging classification system provides a common language to define the extent of cancer within a subgroup and the corresponding prognosis; the system does not define the process of determining a patient's stage, i.e., which diagnostic tests should be used, nor does it provide recommendations on treatment, the committee emphasized.
Physicians should not assume that if the new classification system places patients in a different grouping compared to the old guidelines, their treatment should necessarily change. The system is designed to be a nomenclature tool that helps define prognosis. It is an inappropriate oversimplification to use it as an algorithm to select treatment, according to the IASLC.
The new IASLC staging system was accepted by the American Joint Committee on Cancer (AJCC) and the Union Internationale Contre le Cancer (UICC). It is scheduled to appear in the UICC staging manual in November 2009.
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