IASLC间皮瘤分期：对即将出版的胸膜间皮瘤第9版TNM分期中M描述的建议

国际肺癌研究协会（IASLC）开发了一个全球多中心数据库，为胸膜间皮瘤（PM）第9版肿瘤-淋巴结-转移（TNM）分期提出了循证修订建议。本研究分析了M类别，以验证第8版M类别的建议。

Cases were submitted electronically or by transfer of existing institutional databases for patients with histologically or cytologically confirmed PM. The presence and number of metastases (single versus multiple) in each of eight organ systems were reported for patients with M1 disease at diagnosis. Overall survival (OS) was calculated by the Kaplan-Meier method. Differences in OS were assessed by log-rank test.

对于经组织学或细胞学确诊的PM患者，病例以电子方式提交或通过转移至现有的机构数据库提交。M1疾病患者在诊断时报告了八个器官系统中每个器官系统的肿瘤转移情况和转移瘤数量（单个与多个）。采用Kaplan-Meier法计算总生存期（OS）。通过log-rank检验评估OS的差异。

Of 7,338 submitted cases, 3,598 were eligible 3,221 had sufficient data for clinical staging; 228 cases (7%) were M1. Median overall estimated survival was inferior for M1 compared with M0 patients: 10.5 versus 21.5 months, respectively (p<0.0001); estimated oneyear survival was 46% versus 71%. OS differences between M categories were preserved within histologic subgroups. Among 158 patients with organ-specific documentation of M1 disease, there was no statistically significant difference in OS between those with intrathoracic versus more distant metastatic disease (14.4 months versus 10.9 months, p=0.64). No significant survival difference was detected between patients with metastatic disease in a single organ system versus multiple organ systems (12.6 versus 8.8 months, p=0.45).

在7338例提交的病例中，3598例符合条件，3221例有足够的临床分期数据；M1型228例（7%）。M1患者的中位总体估计生存期低于M0患者：分别为10.5个月和21.5个月（p<0.0001）；估计一年生存率分别为46%与71%。M类别之间的OS差异在组织学亚组内得以保留。在158名有M1疾病器官特异性记录的患者中，胸内转移性疾病与远处转移性疾病患者的OS没有统计学上的显著差异（14.4个月对10.9个月，p=0.64）。单器官系统与多器官系统转移性疾病患者的生存期没有显著差异（12.6个月对8.8个月，p=0.45）。

This evidence-based analysis of the M category for PM conforms with the 8th edition M-descriptors. No changes are proposed in the 9th edition of the mesothelioma M category.

对PM患者 M类别的循证分析符合第8版M描述。因此对第9版间皮瘤M描述没有任何新变化。