2022 World Conference on Lung Cancer (ePosters)-EP13.01-004. Accuracy of Clinical Stage in Resectable Non-small Cell Lung Cancer (NSCLC)

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The accuracy of clinical staging in non-small cell lung cancer (NSCLC) is crucial to minimize unnecessary treatment morbidity and mortality. However, the overall accuracy of current diagnostic modalities is low, ranging from 50-60%. A study conducted by Hye Ran Gwon and colleagues aimed to evaluate the factors that contribute to the accuracy of clinical staging in resectable NSCLC.<br /><br />The study included 811 patients who had undergone curative lung resection surgery at Severance Hospital between January 2019 and December 2020. The 8th AJCC TNM staging system was used, with pathologic staging considered as the gold standard for comparison. The accuracy rates for T, N, and TNM staging were 68.7%, 77.7%, and 85.7%, respectively.<br /><br />Several factors were found to affect the accuracy of clinical staging. Male sex, heavy smoking history, and the presence of diabetes mellitus were associated with lower accuracy. The use of endobronchial ultrasound (EBUS) and the presence of PET uptake were also associated with lower accuracy. In contrast, patients diagnosed in 2020 showed higher accuracy in clinical staging.<br /><br />The study also compared the clinical and pathologic TNM stages. Overall, there was an underestimation of the clinical stage compared to the pathologic stage in 23.1% of cases and an overestimation in 8.3% of cases. The accuracy of clinical staging was lower in patients with higher clinical stage, larger node size, and current smoking history.<br /><br />In conclusion, the accuracy of clinical staging in NSCLC remains suboptimal. Various factors such as sex, smoking history, comorbidities, diagnostic procedures, and year of diagnosis can influence the accuracy of staging. Further efforts are needed to improve the accuracy of clinical staging in order to optimize treatment decisions for patients with NSCLC.

Asset Subtitle

Hye Ran Gwon

Meta Tag

Speaker Hye Ran Gwon

Topic Pulmonology, Radiology, and Staging

Keywords

clinical staging

NSCLC

accuracy

diagnostic modalities

pathologic staging

smoking history

diabetes mellitus

endobronchial ultrasound

PET uptake

treatment decisions