Dr. Forde on Updates to the TNM Staging System in Lung Cancer

Patrick M. Forde, MBBCh, assistant professor of oncology, Johns Hopkins Hospital, discusses updates to the tumor, node, metastasis (TNM) staging system in lung cancer.

The updated TNM staging system has many clinical applications, explains Forde. Historically, when physicians have spoken about early-stage lung cancer and the use of systemic chemotherapy, physicians had to differentiate between stage Ib tumors and stage II tumors because some patients with stage Ib tumors greater than 4 cm received perioperative chemotherapy versus adjuvant chemotherapy for those with stage II disease. In the new set of guidelines, patients with stage Ib disease were moved into the stage II classification where they are now treated with adjuvant chemotherapy, says Forde.

Additionally, patients with oligometastatic lung cancer now have their own classification in the stage IV setting, recognizing that some of those patients may benefit from definitive treatment to both the primary tumor and also the solitary site of metastasis, says Forde.