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Vol. 15. Issue 1.
Pages 67-76 (January - February 2009)
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Vol. 15. Issue 1.
Pages 67-76 (January - February 2009)
Artigo de Revisão/Review Article
Open Access
Projecto de estadiamento do cancro do pulmão pela IASLC: Estudo comparativo entre a 6.ª edição TNM em vigor e a 7.ª edição proposta
The IASLC lung cancer staging project. Comparing the current 6th TNM edition with the proposed 7th edition
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Lina Carvalho1, Edgar Cardoso2, Henrique Nunes2, Victor Baptista2, Ana Gomes3, Patrícia Couceiro3
1 Professora de Anatomia Patológica
2 Disciplina de Oncologia
3 Investigadoras CIMAGO – Centro de Investigação em Meio Ambiente, Genética e Oncologia da Faculdade de Medicina da Universidade de Coimbra
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Resumo

A futura 7.ª edição TNM da Classificação de Tumores Malignos, a publicar em 2009, contempla várias recomendações estabelecidas pela IASLC para alterações nos componentes T, N e M, no que diz respeito ao estadiamento do cancro do pulmão. As alterações no estadiamento global dos doentes, que decorrem destas recomendações, incluem: a reclassificação de tumores com mais de 7cm de T2 para T3; a mudança de algumas categorias dadas a nódulos pulmonares tumorais adicionais em algumas localizações; reclassificar o derrame pleural como componente M; devendo ainda mover-se os casos T2b N0 M0 do estádio IB para o IIA, os casos T2a N1 M0 do estádio IIB para IIA e os casos T4 N0-1M0 do estádio IIIB para IIIA.

Foram aplicadas as definições da nova proposta TNM – 7.ª edição a 203 casos de carcinoma broncopulmonar, correspondendo a carcinoma epidermóide (83) e adenocarcinoma (120) em estádios cirúrgicos, da casuística do Serviço de Anatomia Patológica dos Hospitais da Universidade de Coimbra, tendo-se verificado as seguintes alterações: vinte casos no estádio IB movidos para o estádio IIA e três casos movidos para IIB; dezoito casos no estádio IIB movidos para o estádio IIA e um caso movido para IIIA; dois casos no estádio IIIB movidos para o estádio IV; seis casos no estádio IV movidos para o estádio IIIA e um caso movido para o estádio IIIB. Conclui-se assim que ocorreram alterações de estadiamento global dos doentes em 51 dos 203 casos analisados (25,1%).

Rev Port Pneumol 2009; XV (1): 67-76

Palavras-chave:
7.ª edição TNM
cancro do pulmão
Abstract

The future 7th edition of TNM classification for lung cancer will be published in 2009 and comprises the IASLC recommendations for TNM parameters. The general staging of lung cancer includes the new parameters: reclassification of tumours larger than 7cm from T2 to T3; extra tumoral nodules will change their category to T3, T4 and M1 when in the same, ipsilateral or contralateral lobe, respectively; pleural effusion will be M1a. With these alterations, cases staged as IB – T2b N0 M0 will be IIA, cases staged IIB – T2a N1 M0 will be IIA and cases IIIB– T4 N0-1M0 will be IIIA.

The 7th TNM edition recommendations were applied to 203 broncho-pulmonary carcinomas, concerning epidermoid carcinomas (83) and adenocarcinomas (120) registered in the archive of the Serviço de Anatomia Patológica of the Hospitais da Universidade de Coimbra – Portugal, previously submitted to surgical resection and lymph node excision. The following alterations will be kept as the application of the future 7th TNM edition: 20 cases in stage IB will move to stage IIA (17) and stage IIB (3); 18 cases will change from stage IIB to stage IIA (17) and 1 case to stage IIIA; 2 cases from stage IIIB will move to stage IV; 6 cases in stage IV will move to stage IIIA (5) and 1 case to stage IIIB. In this translational adaptation from 6th to 7th TNM staging, 51 out of the 203 analysed cases change their staging, corresponding to 25.1%.

Rev Port Pneumol 2009; XV (1): 67-76

Key-words:
7th TNM edition
lung cancer
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Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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