Adenocarcinoma of the lung staging: Difference between revisions
Jump to navigation
Jump to search
Shanshan Cen (talk | contribs) |
No edit summary |
||
Line 3: | Line 3: | ||
{{CMG}}; {{AE}} {{SC}} | {{CMG}}; {{AE}} {{SC}} | ||
==Overview== | ==Overview== | ||
Adenocarcinoma of the lung may be classified into several subtypes based on [[TNM]] and [[UICC]] staging system. | Adenocarcinoma of the lung may be classified into several subtypes based on [[TNM]] and [[UICC]] staging system. | ||
==Staging== | ==Staging== | ||
'''TNM staging'''<ref name=canadian>Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab</ref> | '''TNM staging:'''<ref name="canadian">Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab</ref> | ||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center | {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center" | ||
|valign=top| | | valign="top" | | ||
|+ | |+ | ||
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|TNM}} | ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|TNM}} | ||
Line 17: | Line 17: | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |T0 | | style="padding: 5px 5px; background: #DCDCDC;" |T0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No evidence of primary tumor. | | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of primary [[tumor]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |Tis | | style="padding: 5px 5px; background: #DCDCDC;" |Tis | ||
| style="padding: 5px 5px; background: #F5F5F5;" |[[Carcinoma in situ]]. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Carcinoma in situ]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" |T1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] is 3 cm or less in size and has not spread to the [[visceral pleura]] or the main [[Bronchus|bronchi]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T1a – | | style="padding: 5px 5px; background: #F5F5F5;" |T1a – [[Tumor]] is smaller than 2 cm. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T1b – | | style="padding: 5px 5px; background: #F5F5F5;" |T1b – [[Tumor]] is larger than 2 cm, but smaller than 3 cm. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" |T2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |[[Tumor]] is larger than 3 cm, but smaller than 7 cm; or the [[tumor]] has any of the following features: [[Cancer]] has spread to the main [[Bronchus|bronchi]], but is not closer than 2 cm to the [[Carina of trachea|carina]]; [[cancer]] has spread to the [[visceral pleura]]; [[tumor]] is associated with obstructive pneumonitis or [[atelectasis]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T2a – | | style="padding: 5px 5px; background: #F5F5F5;" |T2a – [[Tumor]] is larger than 3 cm, but 5 cm or less in size. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T2b – | | style="padding: 5px 5px; background: #F5F5F5;" |T2b – [[Tumor]] is larger than 5 cm, but 7 cm or less in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |T3 | | style="padding: 5px 5px; background: #DCDCDC;" |T3 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |A | | style="padding: 5px 5px; background: #F5F5F5;" |A [[tumor]] with any of the following: Invasion of the chest wall, [[Thoracic diaphragm|diaphragm]], [[mediastinum|mediastinal]] pleura, or parietal [[pericardium]]; extension into the [[main bronchus]], within 2 cm of the [[Carina of trachea|carina]], but not involving the [[Carina of trachea|carina]]; obstructive pneumonitis of the entire lung. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |T4 | | style="padding: 5px 5px; background: #DCDCDC;" |T4 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |A | | style="padding: 5px 5px; background: #F5F5F5;" |A [[tumor]] with any of: [[Invasive (medical)|Invasion]] of the [[mediastinum]], [[heart]], great vessels, [[Vertebrate trachea|trachea]], [[esophagus]], [[vertebra]], or [[Carina of trachea|carina]]; Separate [[tumor]] [[Nodule (medicine)|nodules]] in the same lobe; malignant [[pleural effusion]]. | ||
|- | |- | ||
| style="padding: 0 5px; background: #4479BA" | | colspan="3" style="padding: 0 5px; background: #4479BA" |{{fontcolor|#FFF| Regional Lymph Nodes}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |NX | | style="padding: 5px 5px; background: #DCDCDC;" |NX | ||
Line 48: | Line 48: | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |N0 | | style="padding: 5px 5px; background: #DCDCDC;" |N0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No lymph nodes involved. | | style="padding: 5px 5px; background: #F5F5F5;" |No [[Lymph node|lymph nodes]] involved. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |N1 | | style="padding: 5px 5px; background: #DCDCDC;" |N1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |[[Metastasis]] to [[ipsilateral]] peribronchial or ipsilateral hilar lymph nodes. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Metastasis]] to [[ipsilateral]] peribronchial or ipsilateral [[Hilum|hilar]] [[Lymph node|lymph nodes]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |N2 | | style="padding: 5px 5px; background: #DCDCDC;" |N2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis to ipsilateral mediastinal or subcarinal lymph nodes. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Metastasis]] to ipsilateral [[Mediastinum|mediastinal]] or subcarinal [[Lymph node|lymph nodes]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |N3 | | style="padding: 5px 5px; background: #DCDCDC;" |N3 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Metastasis to any of: Ipsilateral supraclavicular lymph nodes; Ipsilateral scalene lymph nodes; [[Contralateral]] lymph nodes. | | style="padding: 5px 5px; background: #F5F5F5;" |Metastasis to any of: Ipsilateral supraclavicular [[Lymph node|lymph nodes]]; Ipsilateral scalene [[Lymph node|lymph nodes]]; [[Contralateral]] lymph nodes. | ||
|-|- | |- |- | ||
| style="padding: 0 5px; background: #4479BA" | | colspan="3" style="padding: 0 5px; background: #4479BA" |{{fontcolor|#FFF| Distant Metastasis}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |M0 | | style="padding: 5px 5px; background: #DCDCDC;" |M0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No distant metastasis. | | style="padding: 5px 5px; background: #F5F5F5;" |No distant [[metastasis]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" |M1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Distant metastasis is present. | | style="padding: 5px 5px; background: #F5F5F5;" |Distant [[metastasis]] is present. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M1a – Any one of the following: | | style="padding: 5px 5px; background: #F5F5F5;" |M1a – Any one of the following: separate [[Tumor|tumour]] [[Nodule (medicine)|nodule]](s) in the opposite lung; tumor nodules on the [[parietal pleura]]; [[pleural effusion]] or [[pericardial effusion]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M1b – Distant metastasis. | | style="padding: 5px 5px; background: #F5F5F5;" |M1b – Distant [[metastasis]]. | ||
|} | |} | ||
'''UICC staging'''<ref name=canadian>Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab</ref> | '''UICC staging'''<ref name="canadian">Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab</ref> | ||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center | {| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center" | ||
|valign=top| | | valign="top" | | ||
|+ | |+ | ||
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}} | ! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage}} | ||
Line 101: | Line 101: | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M0 | | style="padding: 5px 5px; background: #F5F5F5;" |M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIA | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T2b | | style="padding: 5px 5px; background: #F5F5F5;" |T2b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |N0 | | style="padding: 5px 5px; background: #F5F5F5;" |N0 | ||
Line 114: | Line 114: | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M0 | | style="padding: 5px 5px; background: #F5F5F5;" |M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIB | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T2b | | style="padding: 5px 5px; background: #F5F5F5;" |T2b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |N1 | | style="padding: 5px 5px; background: #F5F5F5;" |N1 | ||
Line 123: | Line 123: | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M0 | | style="padding: 5px 5px; background: #F5F5F5;" |M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIIA | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T1 | | style="padding: 5px 5px; background: #F5F5F5;" |T1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |N2 | | style="padding: 5px 5px; background: #F5F5F5;" |N2 | ||
Line 148: | Line 148: | ||
| style="padding: 5px 5px; background: #F5F5F5;" |M0 | | style="padding: 5px 5px; background: #F5F5F5;" |M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" |Stage IIIB | ||
| style="padding: 5px 5px; background: #F5F5F5;" |T4 | | style="padding: 5px 5px; background: #F5F5F5;" |T4 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |N2 | | style="padding: 5px 5px; background: #F5F5F5;" |N2 |
Revision as of 14:46, 6 March 2018
Adenocarcinoma of the Lung Microchapters |
Differentiating Adenocarcinoma of the Lung from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Adenocarcinoma of the lung staging On the Web |
American Roentgen Ray Society Images of Adenocarcinoma of the lung staging |
Risk calculators and risk factors for Adenocarcinoma of the lung staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Overview
Adenocarcinoma of the lung may be classified into several subtypes based on TNM and UICC staging system.
Staging
TNM staging:[1]
TNM | Definition | |
---|---|---|
TX | The primary tumour cannot be assessed, or there are malignant cells in the sputum or bronchoalveolar lavage but not seen on imaging or bronchoscopy. | |
T0 | No evidence of primary tumor. | |
Tis | Carcinoma in situ. | |
T1 | Tumor is 3 cm or less in size and has not spread to the visceral pleura or the main bronchi. | |
T1a – Tumor is smaller than 2 cm. | ||
T1b – Tumor is larger than 2 cm, but smaller than 3 cm. | ||
T2 | Tumor is larger than 3 cm, but smaller than 7 cm; or the tumor has any of the following features: Cancer has spread to the main bronchi, but is not closer than 2 cm to the carina; cancer has spread to the visceral pleura; tumor is associated with obstructive pneumonitis or atelectasis. | |
T2a – Tumor is larger than 3 cm, but 5 cm or less in size. | ||
T2b – Tumor is larger than 5 cm, but 7 cm or less in size | ||
T3 | A tumor with any of the following: Invasion of the chest wall, diaphragm, mediastinal pleura, or parietal pericardium; extension into the main bronchus, within 2 cm of the carina, but not involving the carina; obstructive pneumonitis of the entire lung. | |
T4 | A tumor with any of: Invasion of the mediastinum, heart, great vessels, trachea, esophagus, vertebra, or carina; Separate tumor nodules in the same lobe; malignant pleural effusion. | |
Regional Lymph Nodes | ||
NX | Lymph nodes cannot be assessed. | |
N0 | No lymph nodes involved. | |
N1 | Metastasis to ipsilateral peribronchial or ipsilateral hilar lymph nodes. | |
N2 | Metastasis to ipsilateral mediastinal or subcarinal lymph nodes. | |
N3 | Metastasis to any of: Ipsilateral supraclavicular lymph nodes; Ipsilateral scalene lymph nodes; Contralateral lymph nodes. | |
Distant Metastasis | ||
M0 | No distant metastasis. | |
M1 | Distant metastasis is present. | |
M1a – Any one of the following: separate tumour nodule(s) in the opposite lung; tumor nodules on the parietal pleura; pleural effusion or pericardial effusion. | ||
M1b – Distant metastasis. |
UICC staging[1]
Stage | T | N | M |
---|---|---|---|
Occult carcinoma | TX | N0 | M0 |
Stage 0 | Tis | N0 | M0 |
Stage IA | T1 | N0 | M0 |
Stage IB | T2a | N0 | M0 |
Stage IIA | T2b | N0 | M0 |
T1 | N1 | M0 | |
T2a | N1 | M0 | |
Stage IIB | T2b | N1 | M0 |
T3 | N0 | M0 | |
Stage IIIA | T1 | N2 | M0 |
T2 | N2 | M0 | |
T3 | N1 | M0 | |
T3 | N2 | M0 | |
T4 | N0 | M0 | |
T4 | N1 | M0 | |
Stage IIIB | T4 | N2 | M0 |
Any T | N3 | M0 | |
Stage IV | Any T | Any N | M1 |
References
- ↑ 1.0 1.1 Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab