肺癌TNM新分期方案的解读课件.ppt

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1、InterpretationofTNMNewStagingSchemeforLungCancerYongfengYuShanghaiChestHospitalAffiliatedtoShanghaiJiaotongUniversity•1996:idea•1998:committee•1990-2000:databases•2001:finances,CRAB•2002:dataset•2002-2005:dataregistry•2006-2009:publications•2010:7thedition•2009:newda

2、taset•2009-2013:registryofnewcases(1999-2010)•2013-2014:dataanalyses•2015-2016:publications•2017:8thedition7thedition8theditionTimelinesStudypopulationChina,Japan,andSouthKoreacontributedmostofthedatabase-10,294（79%）clinicalstage-23838（79%）pathologicalstagepathologic

3、altypedistribution-adenocarcinomawasthemostcommontype,andbothofclinicalandpathologicalstagingwas64%-squamouscellcarcinoma25%and27%1999-2010lungcancerpatientssubmittedtoCRABN=94708includedinanalysisN=77156SCLCN=6189NSCLCN=70967N=33115M0completeclinical/pathologicalTst

4、aging,detailedTstaginginformationN=13012completeclinicalTstaging,12449casesoperated：.10084(81.0%)cN0.907(7.3%)cN1.1327(10.7%)cN2.131(1.1%)cN3N=30018pathologicalTstagingcompletepTNM0information,exceptforinductiontherapy:.22257（74.2%）pN0.3465（11.5%）pN1.4157（13.9%）pN2.1

5、39（0.5%）pN3completeresectionN=28150（94%）Catalog•Tstagingadjustment:–tumorsize–involvingthemainbronchus–atelectasis/pneumonia–involvingdiaphragmandmediastinalpleura•Otherfactors:–visceralpleuralinvolvement–tumornodulesindifferentlobesofipsilaterallung•Deficienciesandi

6、ssuesneedtobefurtherstudiedCatalog•Tstagingadjustment:–tumorsize–involvingthemainbronchus–atelectasis/pneumonia–involvingdiaphragmandmediastinalpleura•Otherfactors:–visceralpleuralinvolvement–tumornodulesindifferentlobesofipsilaterallung•Deficienciesandissuesneedtobe

7、furtherstudiedTstagingadjustment-tumorsize7theditionProposalT1a:≤2cmT1b：＞2cm，but≤3cmT2a：＞3cm，but≤5cmT2b：＞5cm，but≤7cmT3:＞7cmT1a：≤1cmT1b：＞1cm，but≤2cmT1c：＞2cm，but≤3cmT2a：＞3cm，but≤4cmT2b：＞4cm，but≤5cmT3：＞5cm，but≤7cmT4:＞7cmNewcutpoints1cmupstageupstageupstageNewcutpoints4c

8、mTumorsize-mostprominentfactors3cmisstillthepointofT1andT2;Survivalanalysiswith1cmasasegmentationpoint,tumorsizeincreasingby1cm,the