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Vol. 28. Issue 7.
Pages 360-364 (October 1992)
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Vol. 28. Issue 7.
Pages 360-364 (October 1992)
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La clasificación TNM del carcinoma broncogénico. Seis años después
TNM classification of bronchogenic carcinoma, 6 years after
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A. López-Encuentra
Servicio de Neumología. Universidad Complutense. Hospital 12 de Octubre. Madrid
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La clasificación internacional de extensión anatómica del carcinoma broncogénico (CB) de 1986, permanece totalmente vigente, habiendo sido aceptada en la práctica por todos los grupos interesados. Algunos apartados de esta clasificación (tumor del sulcus superior, adenopatías mediastínicas, T3N2) posiblemente precisen, en el futuro, de modificaciones clasificatorias.

Es imprescindible mencionar explícitamente en qué momento del estudio del paciente ha sido efectuada la clasificación. Si ha sido con los datos disponibles antes de la toracotomía (clasificación clínica) se debe nominar TNM-estadiosc; con los obtenidos macroscópicamente en la toracotomía, TNMq; con los hallazgos microscópicos con las muestras extraidas en toracotomía, TNMq-p.

Dada la existencia de numerosos métodos de estudio para la clasificación de la extensión anatómica, es conveniente señalar cuales han sido utilizados y qué criterios se han seguido para la calificación TNM-estadios, especialmente para la clasificación T3-T4c y N1-N2c. En el CB será necesario considerar una clasificación multifactorial conjunta, útil para predecir pronósticos más ajustados, ampliando la clasificación anatómica de extensión tumoral (TNM-estadios) a variables clínicas, biológicas o celulares-moleculares.

The international classification of anatomical extension of bronchogenic carcinoma dated on 1986, remains valid and has been accepted by all interested groups. However, some of its sections (tumor of sulcus superior, mediastinal adenopathies, T3N2) would require further modifications, specially in aspects related to classification. It is fundamental to mention at which moment of patient's study is the classification made. If the classification has been based on data available before thoracotomy (clinical classification) it should be called TNMstages-c, if was based on macroscopic observation during thoracotomy should be called TNM-q, and if microscopic data of samples obtained during thoracotomy were considered, then, the term TNM-c-q should be used. In view of the existence of a large number of methods available for classifying anatomical extension, the selected method used to qualify TNM-stages, specially T3-T4c and N1-N2c, should be clearly described. In the case of bronchogenic carcinoma a whole multifactorial classification leading to more accurate prognostic predictions should be envisaged. This should include not only classification of the anatomical extension, but also the consideration of some clinical, biological, and cellular variables.

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Copyright © 1992. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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