Comparison of Conventional TNM and Novel TNMB Staging Systems for Non–Small Cell Lung Cancer

Key Points Question Compared with conventional TNM staging for non–small cell lung cancer, does incorporation of a molecular prognostic classifier by the TNMB staging system improve estimation of disease-free survival? Findings In this cohort study of 238 patients who underwent surgical resection of non–small cell lung cancer, 66.8% of patients were reclassified using the molecular prognostic classifier within the TNMB staging system. The eighth edition of the TNM system, compared with the seventh edition of the TNM system, was not associated with improvement of any reclassification measures; however, compared with the TNM eighth edition, use of the TNMB system was associated with improved overall model fit, enhanced identification of high-risk patients, and better differentiation of patients without vs patients with recurrence. Meaning The TNMB staging system may be associated with improved estimation of disease-free survival compared with conventional TNM staging.