Andrew G. Nicholson, Ming S. Tsao, William D. Travis, Deepa T. Patil, Francoise Galateau-Salle, Mirella Marino, Sanja Dacic, Mary Beth Beasley, Kelly J. Butnor, Yasushi Yatabe, Harvey I. Pass, Valerie W. Rusch, Frank C. Detterbeck, Hisao Asamura, Thomas W. Rice, Ramon Rami-Porta, and for the Members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors and Pathology Committees (2018) Eighth Edition Staging of Thoracic Malignancies: Implications for the Reporting Pathologist. Archives of Pathology & Laboratory Medicine: May 2018, Vol. 142, No. 5, pp. 645-661.

REVIEW ARTICLE

Eighth Edition Staging of Thoracic Malignancies: Implications for the Reporting Pathologist

Andrew G. Nicholson, DM; Ming S. Tsao, MD; William D. Travis, MD; Deepa T. Patil, MD; Francoise Galateau-Salle, MD; Mirella Marino, MD; Sanja Dacic, MD; Mary Beth Beasley, MD; Kelly J. Butnor, MD; Yasushi Yatabe, MD, PhD; Harvey I. Pass, MD; Valerie W. Rusch, MD; Frank C. Detterbeck, MD; Hisao Asamura, MD; Thomas W. Rice, MD; Ramon Rami-Porta, MDfor the Members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors and Pathology Committees

From the Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (Dr Nicholson); the Department of Pathology, The Princess Margaret Cancer Centre, Toronto, Ontario, Canada (Dr Tsao); the Department of Pathology (Dr Travis) and the Thoracic Service, Department of Surgery (Dr Rusch), Memorial Sloan-Kettering Cancer Center, New York, New York; the Departments of Pathology (Dr Patil) and Thoracic and Cardiovascular Surgery (Dr Rice), Cleveland Clinic, Cleveland, Ohio; the Departement de Biopathologie, Cancer Center Leon Bernard, Lyon, France (Dr Galateau-Salle); the Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy (Dr Marino); the Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, Mount Sinai Medical Center, New York, New York (Dr Beasley); the Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington (Dr Butnor); the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe); the Department of Thoracic Surgery, New York University, New York, New York (Dr Pass); the Department of Thoracic Surgery, Yale University, New Haven, Connecticut (Dr Detterbeck); the Department of Thoracic Surgery, Keio University, Tokyo, Japan (Dr Asamura); and the Thoracic Surgery Service, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain (Dr Rami-Porta).

The authors have no relevant financial interest in the products or companies described in this article.

Reprints: Andrew G. Nicholson, DM, Royal Brompton & Harefield NHS Trust, Histopathology, Sydney Street, London SW3 6NP, United Kingdom (email: a.nicholson@rbht.nhs.uk).

Context The Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer, in conjunction with the International Mesothelioma Interest Group, the International Thymic Malignancy Interest Group, and the Worldwide Esophageal Cancer Collaboration, developed proposals for the 8th edition of their respective tumor, node, metastasis (TNM) staging classification systems.

Objective To review these changes and discuss issues for the reporting pathologist.

Data Sources Proposals were based on international databases of lung (N = 94 708), with an external validation using the US National Cancer Database; mesothelioma (N = 3519); thymic epithelial tumors (10 808); and epithelial cancers of the esophagus and esophagogastric junction (N = 22 654).

Conclusions These proposals have been mostly accepted by the Union for International Cancer Control and the American Joint Committee on Cancer and incorporated into their respective staging manuals (2017). The Union for International Cancer Control recommended implementation beginning in January 2017; however, the American Joint Committee on Cancer has deferred deployment of the eighth TNM until January 1, 2018, to ensure appropriate infrastructure for data collection. This manuscript summarizes the updated staging of thoracic malignancies, specifically highlighting changes from the 7th edition that are relevant to pathologic staging. Histopathologists should become familiar with, and start to incorporate, the 8th edition staging in their daily reporting of thoracic cancers henceforth.