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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">A futura 7&#46;&#170; edi&#231;&#227;o TNM da Classifica&#231;&#227;o de Tumores Malignos&#44; a publicar em 2009&#44; contempla v&#225;rias recomenda&#231;&#245;es estabelecidas pela IASLC para altera&#231;&#245;es nos componentes T&#44; N e M&#44; no que diz respeito ao estadiamento do cancro do pulm&#227;o&#46; As altera&#231;&#245;es no estadiamento global dos doentes&#44; que decorrem destas recomenda&#231;&#245;es&#44; incluem&#58; a reclassifica&#231;&#227;o de tumores com mais de 7<span class="elsevierStyleHsp" style=""></span>cm de T2 para T3&#59; a mudan&#231;a de algumas categorias dadas a n&#243;dulos pulmonares tumorais adicionais em algumas localiza&#231;&#245;es&#59; reclassificar o derrame pleural como componente M&#59; devendo ainda mover-se os casos T2b N0 M0 do est&#225;dio IB para o IIA&#44; os casos T2a N1 M0 do est&#225;dio IIB para IIA e os casos T4 N0-1<span class="elsevierStyleHsp" style=""></span>M0 do est&#225;dio IIIB para IIIA&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Foram aplicadas as defini&#231;&#245;es da nova proposta TNM &#8211; 7&#46;&#170; edi&#231;&#227;o a 203 casos de carcinoma broncopulmonar&#44; correspondendo a carcinoma epiderm&#243;ide &#40;83&#41; e adenocarcinoma &#40;120&#41; em est&#225;dios cir&#250;rgicos&#44; da casu&#237;stica do Servi&#231;o de Anatomia Patol&#243;gica dos Hospitais da Universidade de Coimbra&#44; tendo-se verificado as seguintes altera&#231;&#245;es&#58; vinte casos no est&#225;dio IB movidos para o est&#225;dio IIA e tr&#234;s casos movidos para IIB&#59; dezoito casos no est&#225;dio IIB movidos para o est&#225;dio IIA e um caso movido para IIIA&#59; dois casos no est&#225;dio IIIB movidos para o est&#225;dio IV&#59; seis casos no est&#225;dio IV movidos para o est&#225;dio IIIA e um caso movido para o est&#225;dio IIIB&#46; Conclui-se assim que ocorreram altera&#231;&#245;es de estadiamento global dos doentes em 51 dos 203 casos analisados &#40;25&#44;1&#37;&#41;&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;1&#41;&#58; 67-76</span></p></span>"
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        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">The future 7th edition of TNM classification for lung cancer will be published in 2009 and comprises the IASLC recommendations for TNM parameters&#46; The general staging of lung cancer includes the new parameters&#58; reclassification of tumours larger than 7<span class="elsevierStyleHsp" style=""></span>cm from T2 to T3&#59; extra tumoral nodules will change their category to T3&#44; T4 and M1 when in the same&#44; ipsilateral or contralateral lobe&#44; respectively&#59; pleural effusion will be M1a&#46; With these alterations&#44; cases staged as IB &#8211; T2b N0 M0 will be IIA&#44; cases staged IIB &#8211; T2a N1 M0 will be IIA and cases IIIB&#8211; T4 N0-1<span class="elsevierStyleHsp" style=""></span>M0 will be IIIA&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">The 7<span class="elsevierStyleSup">th</span> TNM edition recommendations were applied to 203 broncho-pulmonary carcinomas&#44; concerning epidermoid carcinomas &#40;83&#41; and adenocarcinomas &#40;120&#41; registered in the archive of the Servi&#231;o de Anatomia Patol&#243;gica of the Hospitais da Universidade de Coimbra &#8211; Portugal&#44; previously submitted to surgical resection and lymph node excision&#46; The following alterations will be kept as the application of the future 7<span class="elsevierStyleSup">th</span> TNM edition&#58; 20 cases in stage IB will move to stage IIA &#40;17&#41; and stage IIB &#40;3&#41;&#59; 18 cases will change from stage IIB to stage IIA &#40;17&#41; and 1 case to stage IIIA&#59; 2 cases from stage IIIB will move to stage IV&#59; 6 cases in stage IV will move to stage IIIA &#40;5&#41; and 1 case to stage IIIB&#46; In this translational adaptation from 6<span class="elsevierStyleSup">th</span> to 7<span class="elsevierStyleSup">th</span> TNM staging&#44; 51 out of the 203 analysed cases change their staging&#44; corresponding to 25&#46;1&#37;&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;1&#41;&#58; 67-76</span></p></span>"
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Journal Information
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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Bibliografia
[1.]
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The IASLC Lung Cancer Staging Project: proposals regarding the clinical staging of Small Cell Lung Cancer in the forth-coming (seventh) edition of the TNM classification for lung cancer.
J Thorac Oncol, 2 (2007), pp. 1067-1077
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The IASLC Lung Cancer Staging Project: validation of the proposals for revision of the T, N and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification for lung cancer.
J Thorac Oncol, 2 (2007), pp. 694-705
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The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification for lung cancer.
J Thorac Oncol, 2 (2007), pp. 706-714
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The IASLC Lung Cancer Staging Project: Proposals for revision of the N descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer.
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The IASLC Lung Cancer Staging Project: Proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer.
J Thorac Oncol, 2 (2007), pp. 686-693
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Validation of the proposed IASLC Non-small Cell Lung Cancer staging system revisions for advanced bronchioloalveolar carcinoma using data from the California Cancer.
J Thorac Oncol, 2 (2007), pp. 1078-1085
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Validation study of the proposed IASLC staging revisions of the T4 and M non-small cell lung cancer descriptors using data from 23,583 patients in the California Cancer Registry.
J Thorac Oncol, 3 (2008), pp. 216-227
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The International Epidemiology of Lung Cancer. Geographical distribution and secular trends.
J Thorac Oncol, 3 (2008), pp. 819-831
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J.P. Sculier, K. Chansky, J.J. Crowley, et al.
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 tumors and the proposals for the 7th edition.
J Thorac Oncol, 3 (2008), pp. 457-466
[11.]
S.-H.I. Ou, J.A. Zell.
Prognostic significance of the number of lymph nodes removed at lobectomy in stage IA non-small cell lung cancer.
J Thorac Oncol, 3 (2008), pp. 880-886
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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