6 th Reprint Handbook Pages AJCC 7 th Edition

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1 6 th Reprint Handbook Pages AJCC 7 th Edition

2 AJCC 7 th Edition Errata for 6 th Reprint Table 1 Handbook No Significant Staging Clarifications for 6 th Reprint

3 AJCC 7 th Edition Errata for 6 th Reprint Table 2 Handbook

4 DEFINITIONS OF TNM Primary Tumor (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ Nasopharynx T1 Tumor confined to the nasopharynx, or tumor extends to oropharynx and/or nasal cavity without parapharyngeal extension* T2 Tumor with parapharyngeal extension* T3 Tumor involves bony structures of skull base and/or paranasal sinuses T4 Tumor with intracranial extension and/or involvement of cranial nerves, hypopharynx, orbit, or with extension to the infratemporal fossa/masticator space * Note : Parapharyngeal extension denotes posterolateral infiltration of tumor. Oropharynx T1 Tumor 2 cm or less in greatest dimension T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension T3 Tumor more than 4 cm in greatest dimension or extension to lingual surface of epiglottis T4a Moderately advanced local disease Tumor invades the larynx, extrinsic muscle of tongue, medial pterygoid, hard palate, or mandible* T4b Very advanced local disease Tumor invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery * Note : Mucosal extension to lingual surface of epiglottis from primary tumors of the base of the tongue and vallecula does not constitute invasion of larynx. Hypopharynx T1 Tumor limited to one subsite of hypopharynx and 2 cm or less in greatest dimension T2 Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures more than 2 cm but not more than 4 cm in greatest dimension without fixation of hemilarynx T3 Tumor more than 4 cm in greatest dimension or with fixation of hemilarynx or extension to esophagus T4a Moderately advanced local disease Tumor invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, or central compartment soft tissue* T4b Very advanced local disease Tumor invades prevertebral fascia, encases carotid artery, or involves mediastinal structures * Note : Central compartment soft tissue includes prelaryngeal strap muscles and subcutaneous fat. 4 Pharynx 69

5 FIGURE Survival in all NSCLC by TNM stage (according to best based on a combination of clinical and pathologic staging. survival on indicator variables for the newly presented TM categories and an ordered variable for N category, excluding NX cases (Figures 25.4 and 25.5 ). The analysis was performed on a randomly selected training set comprising two-thirds of the available data that met the requirements for conversion to newly presented T and M categories, reserving the other one-third of cases for later validation. The random selection process was stratified by type of database submission and time period of case entry ( vs ). Selection of a final stage grouping proposal from among the candidate schemes was done based on its statistical properties in the training set and its relevance to clinical practice and by consensus. Table 25.2 shows a comparison of the 6th edition and 7th edition TNM for lung cancer to assure clarity for the user. The final 7th edition TNM is described in the Definitions of TNM section that follows. 25 FIGURE Survival in all SCLC by TNM stage (according to best stage based on a combination of clinical and pathologic staging in the IASLC lung database). Lung 313

6 Primary Tumor (T) (continued) T2 Tumor more than 3 cm but 7 cm or less or tumor with any of the following features (T2 tumors with these features are classified T2a if 5 cm or less); Involves main bronchus, 2 cm or more distal to the carina; Invades visceral pleura (PL1 or PL2); Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung T2a Tumor more than 3 cm but 5 cm or less in greatest dimension T2b Tumor more than 5 cm but 7 cm or less in greatest dimension T3 Tumor more than 7 cm or one that directly invades any of the following: parietal pleural (PL3), chest wall (including superior sulcus tumors), diaphragm, phrenic nerve, mediastinal pleura, parietal pericardium; or tumor in the main bronchus (less than 2 cm distal to the carina* but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung or separate tumor nodule(s) in the same lobe T4 Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina, separate tumor nodule(s) in a different ipsilateral lobe *The uncommon superficial spreading tumor of any size with its invasive component limited to the bronchial wall, which may extend proximally to the main bronchus, is also classified as T1a. TABLE Metaanalyses published on the prognostic value of biological or genetic markers for survival in lung cancer Biological variable Prognostic factor Reference bcl-2 Favorable Martin et al TTF1 Adverse Berghmans et al Cox2 Adverse Mascaux et al EGFR overexpression Adverse Nakamura et al Meert et al EGFR mutation Favorable Marks et al ras Adverse Mascaux et al Huncharek et al Ki67 Adverse Martin et al HER2 Adverse Meert et al Nakamura et al VEGF Adverse Delmotte et al Microvascular density Adverse Meert et al p53 Adverse Steels et al Mitsudomi et al Huncharek et al Aneuploidy Adverse Choma et al Adapted from Sculier JP et al. The IASLC Lung Cancer Staging Project: The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th edition of the TNM classification of malignant tumours and the proposals for the 7th edition, J Thorac Oncol 3(4): , 2008, with permission. 316 American Joint Committee on Cancer 2010

7 AJCC 7 th Edition Errata for 6 th Reprint Table 3 Handbook

8 57A Hodgkin and Non-Hodgkin Lymphomas (Excludes ocular adnexal lymphoma) At-A-Glance SUMMARY OF CHANGES There are no changes to the stage groups for the seventh edition ANATOMIC STAGE/PROGNOSTIC GROUPS Stage I Stage II Stage III Stage IV Involvement of a single lymphatic site (i.e., nodal region, Waldeyer s ring, thymus, or spleen) (I); or localized involvement of a single extralymphatic organ or site in the absence of any lymph node involvement (IE) (rare in Hodgkin lymphoma). Involvement of two or more lymph node regions on the same side of the diaphragm (II); or localized involvement of a single extralymphatic organ or site in association with regional lymph node involvement with or without involvement of other lymph node regions on the same side of the diaphragm (IIE). The number of regions involved may be indicated by a subscript, as in, for example, II 3. Involvement of lymph node regions on both sides of the diaphragm (III), which also maybe accompanied by extralymphatic extension in association with adjacent lymph node involvement (IIIE) or by involvement of the spleen (IIIS) or both (IIIE,S). Splenic involvement is designated by the letter S. Diffuse or disseminated involvement of one or more extralymphatic organs, with or without ICD-O-3 TOPOGRAPHY RANGES C00.0 C44.0, C44.2 C68.9, C69.1 C69.4, C69.8 C80.9 ICD-O-3 HISTOLOGY CODE RANGES , , 9735, 9737, , 9837 (all sites) 9823, 9827 (excludes C42.0, C42.1, C42.4) 57 Lymphoid Neoplasms 669