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The AJCC Cancer Staging Manual updates are scheduled to be published on or before October 31, 2016 and will be effective as of
January 1, 2017. With regard to lung cancer staging, more emphasis will be placed on tumor size in the 8th edition in order to
better stratify patient prognosis. Additional changes in the upcoming addition include factors such as diaphragm invasion, tumor
distance from the main stem bronchus, concomitant atelectasis/pneumonitis, changes in nodal status, and changes in the metastatic
category. Although therapeutic changes are not anticipated, the new addition is anticipated to place patients with newly diagnosed
lung cancer into better prognostic categories. As such, as a practicing pathologist, it is essential to have a thorough understanding of
lung cancer staging. The intent of this lecture will be to touch on the AJCC 8th edition updates and to discuss the rationale behind the
various changes. Additionally, challenges will be discussed with regard to staging patients, such as appropriately determining tumor
size, appropriate categorization of lung adenocarcinoma, and determining synchronous primaries versus metastatic lesions.