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    Clinical Evaluation of TNM-7 and TNM-8 Stages in Patients with Non-Small Cell Lung Cancer
    (2022) Gülmez, Ahmet; Akdeniz, Nadiye
    Objectives: The AJCC/UICC TNM (tumor, node, metastasis) classification is a system used to describe the anatomical extent and stage grouping of solid malignant tumors. This system provides a worldwide standardization and is updated periodically. In this study, we aimed to compare the staging of patients with operated Non-Small Cell Lung Cancer (NSCLC) according to TNM-7 and TNM-8. Methods: In this study, we retrospectively analyzed data from 113 NSCLC patients resected without neoadjuvant therapy. Patients with another malignancy diagnosis were excluded from the study. Patients with multiple nodules were excluded because a clear TNM classification could not be made. We evaluated patients individually by restaging them using their post-operative pathology reports. Results: The stage distribution according to TNM7 was as follows: IA: 30 (26.5%), IB: 14 (12,3%), IIA: 36 (31,8%), IIB: 16 (14.2%), IIIA: 13 (11,5%), IIIB: 2 (1,7%). Staging the cases according to TNM8, there is no case was down-staged, 60 (53%) were upstaged; most pronounced between stages IIA (TNM7) to IIB (TNM8), and IIB (TNM7) to IIIA (TNM8). Most of the up stages did not change the adjuvant treatment decision. Approximately 6% of patients experienced a change from IB to IIA. Conclusion: In conclusion, a significant stage change was detected in patients whose stages were reevaluated using TNM7 and TNM8. Most of these upgrades do not change the treatment plan. This stage change may affect the adjuvant treatment decision in a small number of patients. With both classification systems, there was no statistical significance for disease-free survival (DFS) among subgroups, but the statistical significance for overall survival (OS).