ACS：肺癌圆桌战略计划：提升指南一致性肺癌分期（2024）

Farjah F, Barta JA, Wood DE, Rivera MP, Osarogiagbon RU, Smith RA, Mullett TW, Rosenthal LS, Henderson LM, Detterbeck FC, Silvestri GA. The American Cancer Society National Lung Cancer Roundtable strategic plan: Promoting guideline-concordant lung cancer staging. Cancer. 2024 Dec 15;130(24):4167-4176. doi: 10.1002/cncr.34627. Epub 2024 Sep 30. PMID: 39347610; PMCID: PMC11585343.  
The American Cancer Society National Lung Cancer Roundtable strategic plan: Promoting guideline-concordant lung cancer staging - PubMed
The American Cancer Society National Lung Cancer Roundtable strategic plan: Promoting guideline‐concordant lung cancer staging - PMC
The American Cancer Society National Lung Cancer Roundtable strategic plan: Promoting guideline‐concordant lung cancer staging - Farjah - 2024 - Cancer - Wiley Online Library

TABLE 1.  Staging errors and associated consequences

Understaging	Potential consequence(s)
Stage I–III (true stage IV)	Omission of comprehensive biomarker testing
	Omission of systemic therapy
	Unnecessary curative‐intent surgery or radiation therapy
N2 disease (true N3)	Omission of radiation therapy to N3 nodes
Single station N2 (true multi‐station N2)	Unnecessary surgery
	Delay initiating curative‐intent multimodality therapy
N0 (true N1–N3)	Omission of comprehensive biomarker testing
	Omission of systemic therapy
	Unnecessary surgery (multi‐station N2/N3 disease)
	Failure to elicit patient preferences for multimodality therapy (stage IIIA)a
Resectable T4N0‐1 (true unresectable T4N0‐1)	Delay initiating curative‐intent multimodality therapy

Overstaging	Potential consequence(s)
Stage IV (true stage I–III)	Omission of curative‐intent local (stage I) or multimodality therapy (stage II/III)
N3 disease (true N2 disease)	Unnecessary radiation to N3 nodes
Multi‐station N2 (single‐station N2)	Failure to elicit patient preferences for multimodality therapy (stage IIIA)a
N1–3 (true N0)	Unnecessary comprehensive biomarker testing
	Unnecessary systemic therapy
	Omission of curative‐intent surgery or radiation therapy
Unresectable T4N0‐1 (true resectable T4N0‐1)	Omission of surgery

a Patient with single‐station, nonbulky N2 disease defining stage IIIA disease has the option of induction systemic therapy followed by resection versus definitive chemoradiation therapy followed by immunotherapy.

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