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Editorial comment

Staging of ipsilateral pulmonary nodules: back to the future

Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem (Antwerp), Belgium

^_* Corresponding author. Tel.: +32 3 8214360; fax: +32 3 8214396. (Email: paul.van.schil@uza.be).

The first 20% of the full text of this article appears below.

In this manuscript the authors address a very timely question: what is the precise prognosis in patients with non-small cell lung cancer and ipsilateral pulmonary metastases (IPM) in the primary (IPM 1) and non-primary lobe (IPM 2) [1]? Although the number of patients in the IPM 1 and IPM 2 subgroups is rather small, the authors are to be commended for their detailed analysis including prognostic factors in univariate and multivariate analysis. In preparation of the new TNM classification scheduled for clinical implementation in 2009, several reports concluded that there was an unduly upstaging of ipsilateral pulmonary nodules. As indicated by the authors, a lot of clinical studies have demonstrated that IPM in the primary lobe presently considered to be T4 disease, have a better prognosis than the other T4 subgroups. Noteworthy, shortly after the introduction of the revised TNM classification in 1997, this was already addressed by Urschel in . . . [Full Text of this Article]