Skip to main content
Erschienen in: Wiener klinisches Magazin 4/2017

01.09.2017 | Pathologie

Die neue TNM-Klassifikation für Lungentumoren

Änderungen und Bewertung multipler Tumorherde

verfasst von: Alexander Harms, Dr. Mark Kriegsmann, Prof. Dr. Ludger Fink, Dr. Florian Länger, Dr. Arne Warth

Erschienen in: Wiener klinisches Magazin | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

2017 wurde eine neue TNM-Klassifikation für Lungentumoren publiziert, welche zahlreiche Änderungen mit sich bringt. Erstmals gibt es hierbei auch spezifische Regeln, wie mit multifokalen Lungentumoren umzugehen ist. Die vorliegende Arbeit fasst diese neuen Änderungen übersichtlich zusammen und gibt wichtige Anhaltspunkte für die korrekte Anwendung in der Routinediagnostik.
Literatur
1.
Zurück zum Zitat Asamura H, Chansky K, Crowley J et al (2015) The International Association for the study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol 10:1675–1684CrossRefPubMed Asamura H, Chansky K, Crowley J et al (2015) The International Association for the study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol 10:1675–1684CrossRefPubMed
2.
Zurück zum Zitat Campos-Parra AD, Aviles A, Contreras-Reyes S et al (2014) Relevance of the novel IASLC/ATS/ERS classification of lung adenocarcinoma in advanced disease. Eur Respir J 43:1439–1447CrossRefPubMed Campos-Parra AD, Aviles A, Contreras-Reyes S et al (2014) Relevance of the novel IASLC/ATS/ERS classification of lung adenocarcinoma in advanced disease. Eur Respir J 43:1439–1447CrossRefPubMed
3.
Zurück zum Zitat Detterbeck FC, Bolejack V, Arenberg DA et al (2016) The IASLC Lung Cancer Staging Project: background data and proposals for the classification of lung cancer with separate tumor nodules in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:681–692CrossRefPubMed Detterbeck FC, Bolejack V, Arenberg DA et al (2016) The IASLC Lung Cancer Staging Project: background data and proposals for the classification of lung cancer with separate tumor nodules in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:681–692CrossRefPubMed
4.
Zurück zum Zitat Detterbeck FC, Franklin WA, Nicholson AG et al (2016) The IASLC Lung Cancer Staging Project: background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:651–665CrossRefPubMed Detterbeck FC, Franklin WA, Nicholson AG et al (2016) The IASLC Lung Cancer Staging Project: background data and proposed criteria to distinguish separate primary lung cancers from metastatic foci in patients with two lung tumors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:651–665CrossRefPubMed
5.
Zurück zum Zitat Detterbeck FC, Marom EM, Arenberg DA et al (2016) The IASLC Lung Cancer Staging Project: background data and proposals for the application of TNM staging rules to lung cancer presenting as multiple nodules with ground glass or Lepidic features or a pneumonic type of involvement in the forthcoming eighth edition of the TNM classification. Lung Cancer 11:666–680 Detterbeck FC, Marom EM, Arenberg DA et al (2016) The IASLC Lung Cancer Staging Project: background data and proposals for the application of TNM staging rules to lung cancer presenting as multiple nodules with ground glass or Lepidic features or a pneumonic type of involvement in the forthcoming eighth edition of the TNM classification. Lung Cancer 11:666–680
6.
Zurück zum Zitat Detterbeck FC, Nicholson AG, Franklin WA et al (2016) The IASLC Lung Cancer Staging Project: summary of proposals for revisions of the classification of lung cancers with multiple pulmonary sites of involvement in the forthcoming eighth edition of the TNM classification. J Thorac Oncol 11:639–650CrossRefPubMed Detterbeck FC, Nicholson AG, Franklin WA et al (2016) The IASLC Lung Cancer Staging Project: summary of proposals for revisions of the classification of lung cancers with multiple pulmonary sites of involvement in the forthcoming eighth edition of the TNM classification. J Thorac Oncol 11:639–650CrossRefPubMed
7.
Zurück zum Zitat Eberhardt WE, Mitchell A, Crowley J et al (2015) The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 10:1515–1522CrossRefPubMed Eberhardt WE, Mitchell A, Crowley J et al (2015) The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 10:1515–1522CrossRefPubMed
8.
Zurück zum Zitat Fonseca A, Detterbeck FC (2014) How many names for a rose: inconsistent classification of multiple foci of lung cancer due to ambiguous rules. Lung Cancer 85:7–11CrossRefPubMed Fonseca A, Detterbeck FC (2014) How many names for a rose: inconsistent classification of multiple foci of lung cancer due to ambiguous rules. Lung Cancer 85:7–11CrossRefPubMed
10.
Zurück zum Zitat Homer RJ (2015) Pathologists’ staging of multiple foci of lung cancer: poor concordance in absence of dramatic histologic or molecular differences. Am J Clin Pathol 143:701–706CrossRefPubMed Homer RJ (2015) Pathologists’ staging of multiple foci of lung cancer: poor concordance in absence of dramatic histologic or molecular differences. Am J Clin Pathol 143:701–706CrossRefPubMed
11.
Zurück zum Zitat Kadota K, Nitadori J, Woo KM et al (2014) Comprehensive pathological analyses in lung squamous cell carcinoma: single cell invasion, nuclear diameter, and tumor budding are independent prognostic factors for worse outcomes. J Thorac Oncol 9:1126–1139CrossRefPubMedPubMedCentral Kadota K, Nitadori J, Woo KM et al (2014) Comprehensive pathological analyses in lung squamous cell carcinoma: single cell invasion, nuclear diameter, and tumor budding are independent prognostic factors for worse outcomes. J Thorac Oncol 9:1126–1139CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Kadota K, Suzuki K, Kachala SS et al (2012) A grading system combining architectural features and mitotic count predicts recurrence in stage I lung adenocarcinoma. Mod Pathol 25:1117–1127CrossRefPubMedPubMedCentral Kadota K, Suzuki K, Kachala SS et al (2012) A grading system combining architectural features and mitotic count predicts recurrence in stage I lung adenocarcinoma. Mod Pathol 25:1117–1127CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kadota K, Yeh YC, Sima CS et al (2014) The cribriform pattern identifies a subset of acinar predominant tumors with poor prognosis in patients with stage I lung adenocarcinoma: a conceptual proposal to classify cribriform predominant tumors as a distinct histologic subtype. Mod Pathol 27:690–700CrossRefPubMed Kadota K, Yeh YC, Sima CS et al (2014) The cribriform pattern identifies a subset of acinar predominant tumors with poor prognosis in patients with stage I lung adenocarcinoma: a conceptual proposal to classify cribriform predominant tumors as a distinct histologic subtype. Mod Pathol 27:690–700CrossRefPubMed
14.
Zurück zum Zitat Lederlin M, Puderbach M, Muley T et al (2013) Correlation of radio- and histomorphological pattern of pulmonary adenocarcinoma. Eur Respir J 41:943–951CrossRefPubMed Lederlin M, Puderbach M, Muley T et al (2013) Correlation of radio- and histomorphological pattern of pulmonary adenocarcinoma. Eur Respir J 41:943–951CrossRefPubMed
15.
Zurück zum Zitat Liebow AA (1960) Bronchiolo-alveolar carcinoma. Adv Intern Med 10:329–358PubMed Liebow AA (1960) Bronchiolo-alveolar carcinoma. Adv Intern Med 10:329–358PubMed
16.
Zurück zum Zitat Moreira AL, Joubert P, Downey RJ et al (2014) Cribriform and fused glands are patterns of high-grade pulmonary adenocarcinoma. Hum Pathol 45:213–220CrossRefPubMed Moreira AL, Joubert P, Downey RJ et al (2014) Cribriform and fused glands are patterns of high-grade pulmonary adenocarcinoma. Hum Pathol 45:213–220CrossRefPubMed
17.
Zurück zum Zitat Nicholson AG, Chansky K, Crowley J et al (2016) The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the clinical and pathologic staging of small cell lung cancer in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:300–311CrossRefPubMed Nicholson AG, Chansky K, Crowley J et al (2016) The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the clinical and pathologic staging of small cell lung cancer in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 11:300–311CrossRefPubMed
18.
Zurück zum Zitat Rami-Porta R, Asamura H, Goldstraw P (2015) Predicting the prognosis of lung cancer: the evolution of tumor, node and metastasis in the molecular age-challenges and opportunities. Transl Lung Cancer Res 4:415–423PubMedPubMedCentral Rami-Porta R, Asamura H, Goldstraw P (2015) Predicting the prognosis of lung cancer: the evolution of tumor, node and metastasis in the molecular age-challenges and opportunities. Transl Lung Cancer Res 4:415–423PubMedPubMedCentral
19.
Zurück zum Zitat Rami-Porta R, Bolejack V, Crowley J et al (2015) The IASLC Lung Cancer Staging Project: proposals for the revisions of the T Descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 10:990–1003CrossRefPubMed Rami-Porta R, Bolejack V, Crowley J et al (2015) The IASLC Lung Cancer Staging Project: proposals for the revisions of the T Descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 10:990–1003CrossRefPubMed
20.
Zurück zum Zitat Reinmuth N, Stumpf A, Stumpf P et al (2013) Characteristics and outcome of patients with second primary lung cancer. Eur Respir J 42:1668–1676CrossRefPubMed Reinmuth N, Stumpf A, Stumpf P et al (2013) Characteristics and outcome of patients with second primary lung cancer. Eur Respir J 42:1668–1676CrossRefPubMed
21.
Zurück zum Zitat Saji H, Tsuboi M, Shimada Y et al (2013) A proposal for combination of total number and anatomical location of involved lymph nodes for nodal classification in non-small cell lung cancer. Chest 143:1618–1625CrossRefPubMed Saji H, Tsuboi M, Shimada Y et al (2013) A proposal for combination of total number and anatomical location of involved lymph nodes for nodal classification in non-small cell lung cancer. Chest 143:1618–1625CrossRefPubMed
22.
Zurück zum Zitat Shiono S, Yanagawa N (2016) Spread through air spaces is a predictive factor of recurrence and a prognostic factor in stage I lung adenocarcinoma. Interact Cardiovasc Thorac Surg 23(4):567–572CrossRefPubMed Shiono S, Yanagawa N (2016) Spread through air spaces is a predictive factor of recurrence and a prognostic factor in stage I lung adenocarcinoma. Interact Cardiovasc Thorac Surg 23(4):567–572CrossRefPubMed
23.
Zurück zum Zitat Tang ER, Schreiner AM, Pua BB (2014) Advances in lung adenocarcinoma classification: a summary of the new international multidisciplinary classification system (IASLC/ATS/ERS). J Thorac Dis 6:S489–S501PubMedPubMedCentral Tang ER, Schreiner AM, Pua BB (2014) Advances in lung adenocarcinoma classification: a summary of the new international multidisciplinary classification system (IASLC/ATS/ERS). J Thorac Dis 6:S489–S501PubMedPubMedCentral
24.
Zurück zum Zitat Travis WD, Asamura H, Bankier AA et al (2016) The IASLC Lung Cancer Staging Project: proposals for coding T categories for Subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 11:1204–1223CrossRefPubMed Travis WD, Asamura H, Bankier AA et al (2016) The IASLC Lung Cancer Staging Project: proposals for coding T categories for Subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol 11:1204–1223CrossRefPubMed
25.
Zurück zum Zitat Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Proc Am Thorac Soc 8:381–385CrossRefPubMed Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Proc Am Thorac Soc 8:381–385CrossRefPubMed
26.
Zurück zum Zitat Travis WD, Brambilla E, Noguchi M et al (2011) International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 6:244–285CrossRefPubMedPubMedCentral Travis WD, Brambilla E, Noguchi M et al (2011) International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 6:244–285CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Tsao MS, Marguet S, Le Teuff G et al (2015) Subtype classification of lung adenocarcinoma predicts benefit from adjuvant chemotherapy in patients undergoing complete resection. J Clin Oncol 33:3439–3446CrossRefPubMedPubMedCentral Tsao MS, Marguet S, Le Teuff G et al (2015) Subtype classification of lung adenocarcinoma predicts benefit from adjuvant chemotherapy in patients undergoing complete resection. J Clin Oncol 33:3439–3446CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Von Der Thusen JH, Tham YS, Pattenden H et al (2013) Prognostic significance of predominant histologic pattern and nuclear grade in resected adenocarcinoma of the lung: potential parameters for a grading system. J Thorac Oncol 8:37–44CrossRefPubMed Von Der Thusen JH, Tham YS, Pattenden H et al (2013) Prognostic significance of predominant histologic pattern and nuclear grade in resected adenocarcinoma of the lung: potential parameters for a grading system. J Thorac Oncol 8:37–44CrossRefPubMed
29.
Zurück zum Zitat Warth A, Macher-Goeppinger S, Muley T et al (2012) Clonality of multifocal nonsmall cell lung cancer: implications for staging and therapy. Eur Respir J 39:1437–1442CrossRefPubMed Warth A, Macher-Goeppinger S, Muley T et al (2012) Clonality of multifocal nonsmall cell lung cancer: implications for staging and therapy. Eur Respir J 39:1437–1442CrossRefPubMed
30.
Zurück zum Zitat Warth A, Muley T, Kossakowski C et al (2015) Prognostic impact and clinicopathological correlations of the cribriform pattern in pulmonary adenocarcinoma. J Thorac Oncol 10:638–644CrossRefPubMed Warth A, Muley T, Kossakowski C et al (2015) Prognostic impact and clinicopathological correlations of the cribriform pattern in pulmonary adenocarcinoma. J Thorac Oncol 10:638–644CrossRefPubMed
31.
Zurück zum Zitat Warth A, Muley T, Kossakowski CA et al (2015) Prognostic impact of intra-alveolar tumor spread in pulmonary adenocarcinoma. Am J Surg Pathol 39:793–801CrossRefPubMed Warth A, Muley T, Kossakowski CA et al (2015) Prognostic impact of intra-alveolar tumor spread in pulmonary adenocarcinoma. Am J Surg Pathol 39:793–801CrossRefPubMed
32.
Zurück zum Zitat Warth A, Muley T, Meister M et al (2012) The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. J Clin Oncol 30:1438–1446CrossRefPubMed Warth A, Muley T, Meister M et al (2012) The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. J Clin Oncol 30:1438–1446CrossRefPubMed
33.
Zurück zum Zitat Wei S, Asamura H, Kawachi R et al (2011) Which is the better prognostic factor for resected non-small cell lung cancer: the number of metastatic lymph nodes or the currently used nodal stage classification? J Thorac Oncol 6:310–318CrossRefPubMed Wei S, Asamura H, Kawachi R et al (2011) Which is the better prognostic factor for resected non-small cell lung cancer: the number of metastatic lymph nodes or the currently used nodal stage classification? J Thorac Oncol 6:310–318CrossRefPubMed
34.
Zurück zum Zitat Weichert W, Kossakowski C, Harms A et al (2016) Proposal of a prognostically relevant grading scheme for pulmonary squamous cell carcinoma. Eur Respir J 47:938–946CrossRefPubMed Weichert W, Kossakowski C, Harms A et al (2016) Proposal of a prognostically relevant grading scheme for pulmonary squamous cell carcinoma. Eur Respir J 47:938–946CrossRefPubMed
35.
Zurück zum Zitat Weichert W, Warth A (2014) Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med 20:309–316CrossRefPubMed Weichert W, Warth A (2014) Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med 20:309–316CrossRefPubMed
36.
Zurück zum Zitat Yoshizawa A, Motoi N, Riely GJ et al (2011) Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol 24:653–664CrossRefPubMed Yoshizawa A, Motoi N, Riely GJ et al (2011) Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol 24:653–664CrossRefPubMed
Metadaten
Titel
Die neue TNM-Klassifikation für Lungentumoren
Änderungen und Bewertung multipler Tumorherde
verfasst von
Alexander Harms
Dr. Mark Kriegsmann
Prof. Dr. Ludger Fink
Dr. Florian Länger
Dr. Arne Warth
Publikationsdatum
01.09.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 4/2017
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-017-0181-2

Weitere Artikel der Ausgabe 4/2017

Wiener klinisches Magazin 4/2017 Zur Ausgabe

Panorama

Panorama