IASLC Staging Reference Cards, 9th Edition-IASLC Staging Reference Cards, 9th Edition

IASLC Staging Reference Cards, 9th Edition
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The document from the International Association for the Study of Lung Cancer (IASLC) outlines extensive revisions and classifications for lung and various thoracic cancers in its ninth edition of the TNM classification. The detailed updates focus on the T (tumor), N (lymph nodes), and M (metastasis) descriptors and staging for lung cancer, incorporating changes and proposals from recent publications and expert consensus.<br /><br />### Lung Cancer Classification<br />- **Tumor (T) Descriptors**:<br />  - **T1**: Tumor ≤3 cm (subdivided into T1a, T1b, and T1c based on size).<br />  - **T2**: Tumors 3-5 cm or with specific features like visceral pleura invasion (further divided into T2a and T2b).<br />  - **T3**: Tumors 5-7 cm or invasion into parietal pleura/chest wall, etc.<br />  - **T4**: Tumors >7 cm or those invading crucial structures like the heart, great vessels, or multiple lobes.<br /><br />- **Nodal (N) Descriptors**:<br />  - **N0**: No regional lymph node metastasis.<br />  - **N1**: Metastasis to ipsilateral peribronchial or hilar lymph nodes.<br />  - **N2**: Metastasis to ipsilateral mediastinal/subcarinal nodes (further divided into N2a and N2b).<br />  - **N3**: Metastasis to contralateral or supraclavicular nodes.<br /><br />- **Metastasis (M) Descriptors**:<br />  - **M1a**: Separate tumor nodules in the contralateral lobe, pleural, or pericardial nodules/effusion.<br />  - **M1b**: Single extrathoracic metastasis.<br />  - **M1c**: Multiple extrathoracic metastases (subdivided into M1c1 and M1c2 based on the organ system involvement).<br /><br />### Key Revisions for Other Thoracic Cancers<br />- **Thymic Epithelial Tumors**:<br />  - Detailed descriptions are provided for T, N, and M categories, reflecting the extent of invasion and nodal involvement. Staging includes T categories based on dimensions and invasion levels, such as T1 (≤5 cm), T2 (invading pericardium), T3 (invading brachiocephalic vein or SVC), and T4 (invading aorta or myocardium).<br />  - **N Categories**: N0 (no nodes), N1 (anterior nodes), N2 (deep or cervical nodes).<br />  - **M Categories**: M0 (no metastasis), M1 (metastasis with subcategories for pleural or distant organ involvement).<br /><br />### Esophageal and Esophagogastric Junction Cancer<br />- Description of site-specific T categories, N stages involving various lymph nodes, and M stages indicating distant metastasis.<br />- Clinical and pathological staging are detailed, incorporating various primary tumor sizes, node involvement, and metastasis descriptions.<br /><br />### Pleural Mesothelioma<br />- Updated T descriptors that include clinical (cT) and pathological (pT) staging based on pleural involvement and invasive extent to adjacent structures.<br />- N classifications involve ipsilateral and contralateral lymph nodes.<br />- M classifications address distant metastasis with secondary emphasis on pleural conditions.<br /><br />### 2021 WHO Classifications<br />- The document extensively discusses updates for invasive lung adenocarcinoma, mesothelioma, and squamous cell carcinoma, with diagnostic features, histological patterns, and recommendations for small biopsies and cytology samples.<br />- The guide emphasizes accurate histo-pathological classification based on different morphological and IHC staining patterns, crucial for effective diagnosis and treatment planning.<br /><br />Overall, the ninth edition of the TNM classification by the IASLC presents a comprehensive and systematic update on lung and thoracic cancers, providing crucial guidance for clinical practice, research, and staging standardization.
Keywords
IASLC
TNM classification
lung cancer
thoracic cancers
tumor descriptors
nodal descriptors
metastasis descriptors
thymic epithelial tumors
esophageal cancer
pleural mesothelioma