Comments on the Eighth Edition of the TNM Classification for Lung Cancer Radical changes and limitations: Does size matter?
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Cardiothoracic surgeon, Thorax Center, Corfu, Greece
Anesthesiologist, Algos Pain Center, Corfu, Greece
Department of Thoracic Surgery, Metaxa Memorial Cancer Hospital, Piraeus, Greece
Department of Thoracic Surgery, Sismanogleio General Hospital, Athens, Greece
Oncology Unit, 3rd Department of Medicine, Athens Medical School, Sotiria Chest Diseases Hospital, Athens, Greece
Department of Surgery, Ioannina University Hospital, Ioannina Greece
Department of Cardiothoracic Surgery, Ioannina University Hospital, Ioannina, Greece
Corresponding author
Stefanos Nikolouzos   

Thorax Centre, 2A Ioannis Romanos Street, 49132 Corfu, Greece
Pneumon 2017;30(2):77-84
Staging of cancer at the time of diagnosis is the most important predictor of survival, and treatments options should be based on the stage. The aim of this overview is to discuss the changes in the 8th classification of lung cancer and its impact on predicting patients’ prognosis. Potential limitations of the classification and future directions are discussed.

A systematic literature search was performed to identify relevant reports. Studies and articles were identified using online searches of The U.S. National Library of Medicine via www.pubmed.com. The whole article is based on the IASLC Staging and Prognostic Factors Committee report. An international lung cancer database was developed from 35 sources in 16 countries around the globe with staging and outcome data on 94708 lung cancer cases.

This new edition of lung cancer TNM staging placed additional emphasis on tumor size and size cut points have further added. The node classification remained unchanged in the new edition. It also emphasizes on the different prognostic value of single o multiple metastatic foci.

New staging is based on analyzing survival in large databases based on tumor size and disease proliferation and therefore is expected to assess an individual patient’s prognosis more accurately. It is evident that an improved survival may eflects improvements in diagnosis and treatment. This eighth edition of the TNM classification for lung cancer placed additional emphasis on tumor size.

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