Annabelle Fonseca1, Frank C Detterbeck2. 1. General Surgery Resident, Yale School of Medicine, PO Box 208062, New Haven, CT 06520-8062, United States. 2. Yale School of Medicine, Thoracic Surgery, PO Box 208062, New Haven, CT 06520-8062, United States. Electronic address: frank.detterbeck@yale.edu.
Abstract
OBJECTIVES: Stage classification is important because it allows consistent definition of patient groups, and thus provides a foundation for comparison of outcomes. For patients with multiple pulmonary foci of lung cancer, however, the classification rules are ambiguous and confusing. MATERIALS AND METHODS: We surveyed experts and clinicians who regularly evaluate patients with lung cancer to see how similar or different their interpretation of the official stage classification was for such patients. RESULTS: We found a great deal of inconsistency in how four clinical scenarios were classified. No method of classification was chosen by a majority when there were more than two choices allowed by the classification rules. In a scenario with pulmonary foci of cancer of different histologic types, 86% classified this as separate primary cancers and 14% as multifocal lung cancer. CONCLUSION: The marked variability in classification must be taken into account when interpreting reported outcomes of patients with multiple pulmonary foci of lung cancer.
OBJECTIVES: Stage classification is important because it allows consistent definition of patient groups, and thus provides a foundation for comparison of outcomes. For patients with multiple pulmonary foci of lung cancer, however, the classification rules are ambiguous and confusing. MATERIALS AND METHODS: We surveyed experts and clinicians who regularly evaluate patients with lung cancer to see how similar or different their interpretation of the official stage classification was for such patients. RESULTS: We found a great deal of inconsistency in how four clinical scenarios were classified. No method of classification was chosen by a majority when there were more than two choices allowed by the classification rules. In a scenario with pulmonary foci of cancer of different histologic types, 86% classified this as separate primary cancers and 14% as multifocal lung cancer. CONCLUSION: The marked variability in classification must be taken into account when interpreting reported outcomes of patients with multiple pulmonary foci of lung cancer.
Authors: Konstantinos Leventakos; Tobias Peikert; David E Midthun; Julian R Molina; Shanda Blackmon; Francis C Nichols; Yolanda I Garces; Christopher L Hallemeier; Stephen J Murphy; George Vasmatzis; Sarah L Kratz; William P Holland; Charles F Thomas; John J Mullon; K Robert Shen; Stephen D Cassivi; Randolph S Marks; Marie Christine Aubry; Alex A Adjei; Ping Yang; Mark S Allen; Eric S Edell; Dennis Wigle; Aaron S Mansfield Journal: J Thorac Oncol Date: 2017-06-03 Impact factor: 15.609