Maria Joao Klusmann MD, Presenter: Nothing to Disclose

Kirupa Haran Jogeesvaran FRCR, MRCP, Abstract Co-Author: Nothing to Disclose

Arjun Nair MBBS, Abstract Co-Author: Nothing to Disclose

Sisa Grubnic MD, Abstract Co-Author: Nothing to Disclose

Siobhan Johanna Green MBBS, Abstract Co-Author: Nothing to Disclose

Ioannis Vlahos MBBS, Abstract Co-Author: Research grant, Bayer AG Support, Bayer AG Research Consultant, Siemens AG

Changes to the current NSCLC TNM staging are proposed by the International Association for the Study of Lung Cancer (IASLC) for the 2009 edition. This exhibit aims to: · Summarize the proposed T&M changes · Explain the new Stage Groupings · Analyze the impact of Stage Migration · Highlight persistent limitations of the proposal  

Source: Tertiary NSCLC service; 250 cases prospectively evaluated using both new and old TNM: · T&M reclassification tables, mortality data premise. · Nodal “zonal” proposal explained. · New Staging Groups – imaging depiction-T2/T3,T4 downsizing -same lobe/lung nodule impact, pleural, M1a v M1b disease. · Schematics to aid staging. · Stage migration case illustrations – IIIA/IIIB an operable threshold? · Limitations- Lymphangitis, PET-SUV, Extrathoracic nodes, Multifocal BAC, etc.  

The main teaching points of the exhibit are: · The proposed TNM changes have evolved to better reflect the prognostic relevance of the various descriptors used · Accurate multidimensional measurement of greatest tumour dimension will be more critical, with 2,3,5 and 7cm cut-off points · Same lobe/lung tumours may be downstaged to IIIA or IIB resulting in more patients being offered surgery · Nodal staging remains unaltered · Several imaging and clinical limitations remain unaddressed  

Klusmann, M, Jogeesvaran, K, Nair, A, Grubnic, S, Green, S, Vlahos, I, Proposed Revisions to the TNM Staging of Non-Small Cell Lung Cancer (NSCLC): Rationale—Clinico-Radiological Implications and Persistent Limitations.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008659.html