A Comparative Study Of The Old And New TNM Staging System For Non-Small Cell Lung Cancer

ObjectiveTNM staging system is the most important basis for the formulating of the individual treatments for patients with lung cancer. The fifth edition of TNM staging system for the non-small cell lung cancer has got affirmation and promotion during the past 20 years, but also appeared a lot of problems and disputes. The seventh edition of the TNM staging system officially announced on the 13 th world conference on lung cancer. This study intends to compare the old and new TNM staging system for non-small cell lung cancer and estimate whether the new one is still exist shortages.Materials and methodsRetrospectively analyses the patients of Shengjing Hospital of China Medical University with NSCLC, collects the basic, clinical stage and survival information. Respectively use the two TNM staging system, proceeds survival analysis by using the method of Kaplan-Meier, and draw the survival curves. Respectively uses the method of Log rank and cumulate theχ2 and P values, and estimate the difference between the old and new staging system. Statistical analysis is conducted by SPSS 13.0.ResultsA total of 352 patients with NSCLC were ultimately enrolled in the study. According to the old and new staging system, the biggest changes of the staging is 10 casesⅠB change to 6 casesⅡA and 4 casesⅡB,90 casesⅢB change toⅣ;5 casesⅣchange toⅢB. The different of survival between adjacent stages of the old and new staging systems:betweenⅠB andⅠA, there is statistically significant differences (P:0.002 VS 0.000);ⅡA and I B, the new staging is better than the old one (P:0.045 VS 0.542);ⅡB andⅡA, there are statistically significant differences in the two staging systems (P:0.003 VS 0.047);ⅢA andⅡB, there are significant differences in the old one, but the new one not (P:0.376 VS 0.084);ⅢB andⅢA, there are significant differences in the new one, but the old one not (P:0.004 VS 0.068);ⅣandⅢB, there are significant differences in the new one, but the old one not (P: 0.011 VS 0.983).ConclusionCompared with the fifth edition of staging system, the seventh one is more accurate. And the new staging system is also applicable to patients with non-small cell lung cancer in China. It makes progress in judging the prognosis of patients with NSCLC in china and is worth popularizing. Of course, this staging system has not been perfect yet. It need to be improved in the future.