Higher PEEP , Low Tidal Volume Didn ’ t Lower Mortality

A update of the lung cancer staging system probably was long overdue because the old system was based on patients treated with surgery alone. And with greater numbers of patients with which to make staging classifications, the process of developing the staging system “has changed irrevocably,” according to Dr. Peter Goldstraw at the annual meeting of the Society of Thoracic Surgeons. The current edition of the TNM Classification of Malignant Tumors has not updated lung cancer staging since 1997, and even then, the changes made were minor. Moreover, the stagings in the initial edition were based on only 5,319 total cases, all of which were treated with surgery alone, and some of the subsets were established based on fewer than 100 cases. The new, proposed system, which is scheduled to be published in 2009, made use of data collected from more than 100,000 cases, including some who got chemotherapy alone and some who got radiotherapy alone. Moreover, the sheer number of patients allowed for about 17,000 cases to be used to establish the new, revised system and 9,000 cases to validate it, said Dr. Goldstraw, the head of the thoracic surgery section at the Royal Brompton Hospital, London, who chaired the Staging Committee of the International Association for the Study of Lung Cancer, the group that developed the revisions. “Such intensive validation has