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Yale Experts Summarize Impact of New Lung Cancer Staging System

For Immediate Release
Date: 07/07/09
Contact: Renee Gaudette, (203) 436-8533, or renee.gaudette@yale.edu

New Haven, Conn. —In response to a newly adapted international staging system for lung cancer, Yale Cancer Center Thoracic Oncology Program leadership recently published a comprehensive review of the system. “The new stage classification system represents an unprecedented international effort that for the first time creates a very robust scientific basis for the stage classification,” explained Dr. Frank Detterbeck, Co-Director of the Yale Cancer Center (YCC) Thoracic Oncology Program and Professor of Thoracic Surgery.  “The quality of the scientific analysis behind the new classification system is superb.  It involves detailed analysis and extensive internal and external validation and has not been duplicated in any other cancer type,” Dr. Detterbeck said.

The new system is the culmination of 10 years of work by the International Association for the Study of Lung Cancer (IASLC), which assembled a database of over 100,000 lung cancer patients from 20 countries that dwarfs the previous database of around 5,000 patients.  The data was carefully analyzed, and led to recommendations which have been endorsed by the official governing bodies for cancer classification, the Union Internationale Contre le Cancer (UICC) and American Joint Commission on Cancer. The new stage classification system will be formally published in the UICC Cancer Staging Manual in November.

Drs. Detterbeck, Daniel Boffa, and Lynn Tanoue wrote the review of the lung cancer classification system featured in the July issue of CHEST, the journal publication of the American Association of Chest Physicians.

“The importance of an accurate definition of a patient’s cancer stage cannot be overemphasized,” said Dr. Tanoue, Co-Director of the YCC Thoracic Oncology Program and Professor of Pulmonology. “It is crucial in determining the best treatment for a patient.  The new stage classification system allows us to more precisely define a patient’s prognosis and enhances our ability to share results with colleagues internationally.” 

The new staging system includes definitions of additional subgroups of lung cancer and further subdivides the size and extent of the primary tumor.  In addition, some subgroups that were previously combined in the former staging system are now classified differently because of improved prognosis and treatment options for the disease.  “The dramatic increase in data on lung cancer inevitably makes the system more complex,” explained Dr. Detterbeck.  “This explosion of knowledge highlights the need for patient care to be provided not by individual physicians, but by a team of physicians that use their collective wisdom to make the right decisions.”

The foundation for cancer staging is anatomical, using T, N, and M descriptors.  In lung cancer, the T descriptor refers to the size and the extent of invasion of the primary lung tumor into adjacent normal tissues. The N descriptor identifies the extent of spread of cancer cells into lymph nodes within the lung or chest. Finally, the M descriptor recognizes to the extent of the spread of the cancer to other areas of the body.

Established in 1974, Yale Cancer Center was one of the first university-based comprehensive cancer centers designated by the National Cancer Institute.  Today, it is one of a select network of only 40 in the United States, and the only one in Southern New England.  Bringing together the resources of Yale-New Haven Hospital and the Yale University School of Medicine, its mission encompasses patient care, research, cancer prevention and control, community outreach, and education. For more information on the Center, please go to www.yalecancercenter.org