G.F.C. Wenckebach, MD; D.W. Chamberlain, MD, PhD;
F. Alexander, MD; R.S. Fraser, MD; A. Kolin, MD; T. Newman

At present, the most accurate prognostic indicator for lung cancer is tumor stage^(1,2); cell type is the second most valuable variable⁽³⁾. Therefore, crucial tasks for the pathologist are to record the data from pathologic examination of the resection specimen and to accurately type the cancer. The guidelines presented here are intended to help pathologists carry out these functions.

The guidelines have been developed with the input of the Lung Cancer Disease Site Group of the Cancer Care Ontario Practice Guidelines Initiative and the Lung Working Group of the Pathology/Oncology Workshop on Synoptic Reporting (Dec. 1998), National Cancer Institute of Canada. The impetus for the workshop came from the Canadian Committee on Cancer Staging, in recognition of the need for pathology reports to include data essential for defining prognosis, best patient management options, and the patient population eligible for inclusion in clinical trials, as well as for outcome analyses.

The Primary Lung Cancer Check-off Sheet (Appendix 1) offers a convenient and comprehensive tool for pathologists to describe to non-laboratory physicians the results of their examination of tumor resection specimens and the histologic type and grade of tumor. It incorporates the recently revised Regional Lymph Node Classification System (Appendix 2) and the categories of the International Staging System for Lung Cancer (TNM classification, Appendix 4)⁽⁴⁾ adopted by the International Union Against Cancer (UICC)⁽⁵⁾ and the American Joint Committee on Cancer (AJCC)⁽⁶⁾. The new WHO classification of pulmonary carcinomas (Appendix 3) is recommended. Criteria are provided (Appendix 5) that will be helpful in classifying primary lung carcinoma.