The International Association for the Study of Lung Cancer International Staging Project on Lung Cancer

The tumor, node, metastasis system for cancer staging evolved in the middle of the last century. It was adopted for the staging of lung cancer by the American Joint Committee on Cancer in 1973 and used by the Union Internationale Contre le Cancer (UICC) in 1974 for its second edition of the Classification of Malignant Disease. Subsequent revisions of the international tumor, node, metastasis staging system in lung cancer, up to and including the fifth revision enacted in January 1997, were largely based on Dr. Clifton Mountain's database in Houston. The International Association for the Study of Lung Cancer established its International Staging Committee in 1997 to collect data on lung cancer cases from around the world treated by all modalities. This project has now collected over 100,000 cases and has been accepted as the primary source of recommendations by the UICC for the next revision of the International Staging System for Lung Cancer due to be enacted in January of 2009. This article describes the achievements of this project and the present state of the database. The authors set out the steps that are necessary before the International Association for the Study of Lung Cancer is able to submit its recommendations to the UICC at the end of 2006. Subject to editorial review, these recommendations will be disseminated to the lung cancer community through a series of publications in this Journal. This article will set the scene for these subsequent publications and, possibly, will garner support and ideas for the next phase of this long-term project.