ITMIG conducted 2 workshops that took place at the Yale Cancer center West Campus on November 15 and 16. The first workshop focused on a review of current data on prognostic factors, and potential new factors, while the second tackled areas of ambiguity, so that moving forward ITMIG would have a more consistent and well-defined language, and would employ policies and procedures that are crucial for accurate data collection. The goal of these events was to lay the foundation for a prospective database as well as the development of an official stage classification for the 8th edition of the UICC/AJCC staging manual.
These workshops represented summit meetings to debate and integrate the work of multiple specific workgroups (listed in the table). These workgroups consisted of core teams of 5-8 people and extended teams of 12-20 people. These individuals had all invested a great deal of effort to develop proposals for how to address issues and sources of confusion that are impeding progress. Each workgroup had produced a draft paper, which was circulated to all members of all workgroups, and was presented at the summit meeting (Figure 1). The proposals were critically evaluated and constructively debated in the general forum, after which each workgroup reassembled to refine their proposals (Figure 2). These were then re-presented to the group to see if a reasonable and internally consistent consensus had been achieved. It was definitely a lively yet constructive working meeting.
The participants included individuals from all specialties and many countries, consistent with the international nature of the ITMIG effort. It also included Ramon Rami-Porta (Chair of the International Staging committee), Dori Giroux (biostatistician from CRAB, i.e. Cancer Research and Biostatistics) and Ann Christine Catlin (director of informatics at HUBzero). The meeting also featured lectures on what makes a prognostic factor robust, and on the development of a highly structured multifaceted prospective database, consistent with the ITMIG philosophy of not just doing the usual, but striving to use (and in part develop) the most sophisticated tools and approaches available.
The next step is for the workgroups to massage the documents into publishable papers that outline the rationale and proposed approach to addressing sources of confusion. This series of papers will be sent to all ITMIG member for further critical evaluation. With this input these will be revised into final documents that represent an ITMIG consensus of how to move ahead. These will be published in a special supplement issue of the Journal of Thoracic Oncology which will be available in print by July of 2011 (when we expect to fully implement the prospective database in HUBzero). This supplement issue should serve as a reference dictionary for everyone active in this field.
The commitment of a large number of individuals in struggling with the issues and developing the proposals over a relatively short period of time is impressive. It is what has allowed ITMIG to gain a lot of strength and recognition. It is remarkable that 6 months after the birth of the organization, we are well on the way to having addressed many barriers to progress, are well underway to assemble retrospective and prospective global databases, and have the approval of IASLC, UICC and AJCC to develop an official stage classification. Another workshop is scheduled for March 25-27 to address issues related to histologic evaluation of thymic malignancies. To be sure, there is a great deal of work ahead of us. But the collaborative spirit, degree of dedication, and amount of momentum that has been achieved give us a really unique opportunity to make a difference.
Researchers should cite this work as follows:
James Huang; Ann Christine Catlin (2011), "ITMIG Workshops on Prognostic Factors and Definitions, Policies and Procedures," http://ccehub.org/resources/367.