P1.03-065 Comparison of the Proposed IASLC 8th TNM Lung Cancer Staging System to the 7th Edition

Abstract

We performed a validation study of the proposed International Association for the Study of Lung Cancer (IASLC) 8th tumor, node, metastasis (TNM) and grouping revisions on the non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in our Institution, where we are a regular contributor of a subset of cases for the IASLC TNM staging revision projects. Data was collected from the Queensland Cancer Control Analysis Team (QCCAT) Queensland Oncology Online (QOOL) registry of NSCLC or SCLC cases presented to The Prince Charles Hospital (TPCH) between 2000 and 2015. It was validated against Queensland Integrated Lung Cancer Outcomes Project (QILCOP) registry with case identification number, first name, last name, and date of birth. Cases were classified according to IASLC TNM revisions 7th edition and then according to the proposed TNM revisions and stage groupings where data available. Kaplan-Meier curves were plotted and survival differences tested with Log-Rank test using SPSS Statistics ver. 23. The entire study population consisted of three thousand six hundred and thirty-seven cases. One thousand three hundred and ninety-two non-surgical patients had complete clinical staging and one thousand and fifteen patients with pathological staging were identified. Median survival in clinical staging by the 7th edition showed progressive reduction in median survival with increasing Stage (IA:1480, IB:714, IIA:715, IIB:391, IIIA:399, IIIB285, IV:196; days) which was similar in the proposed 8th edition staging noting small numbers in IA1 (IA1:1385, IA2:2098, IA3:1004, IB:801, IIA:550, IIB:589, IIIA:448, IIIB285, IIIC:265, IVA:218, IVB:106; days). A similar pattern was reflected in pathological staging 7th edition TNM staging (IA:3725, IB:3486, IIA:1796, IIB:1209, IIIA:841, IIIB:587, IV:869; “days”) and in the proposed 8th edition staging (IA1:1929, IA2:3586, IA3:3804, IB:3640, IIA:2977, IIB:1796, IIIA:949, IIIB:723, IVA:869; “days”). Log-Rank test in all the survival curves were <0.001. The proposed 8th edition TNM classification appears to be a more refined predictor of prognosis. However, our cohort only had small sample sizes for Stage I cases, which need validation and further hazard ratio and multivariate analysis is recommended. Acknowledgements: patients and staff at TPCH and UQTRC