Lung cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Kim-Son H. Nguyen, M.D., M.P.A., Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA, Cafer Zorkun, M.D., Ph.D. [2]

Overview

Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is an important factor affecting the prognosis and potential treatment of lung cancer.

Non-small cell lung carcinoma is staged from IA ("one A", best prognosis) to IV ("four", worst prognosis).^[1] Small cell lung carcinoma is classified as limited stage if it is confined to one half of the chest and within the scope of a single radiotherapy field. Otherwise it is extensive stage.^[2]

Primary tumor

Tis - Carcinoma in situ
TX - Positive malignant cytologic findings, no lesion observed
T1 - Diameter of 3 cm or smaller and surrounded by lung or visceral pleura or endobronchial tumor distal to the lobar bronchus
T2 - Diameter greater than 3 cm ; extension to the visceral pleura, atelectasis, or obstructive pneumopathy involving less than 1 lung; lobar endobronchial tumor; or tumor of a main bronchus more than 2 cm from the carina
T3 - Tumor at the apex; total atelectasis of 1 lung; endobronchial tumor of main bronchus within 2 cm of the carina but not invading it; or tumor of any size with direct extension to the adjacent structures (i.e. chest wall mediastinal pleura, diaphragm, pericardium parietal layer).
T4 - Invasion of the mediastinal organs (i.e esophagus, trachea, carina, great vessels, heart), obstruction of the superior vena cava; involvement of a vertebral body; recurrent nerve involvement; malignant pleural effusion, malignant pericardial effusion; or satellite pulmonary nodules within the same lobe as the primary tumor

Regional lymph node involvement

N0 - No lymph nodes involved
N1 - Ipsilateral hilar nodal involvement
N2 - Ipsilateral mediastinal involvement
N3 - Contralateral mediastinal or hilar nodal involvement or any scalene or supraclavicular nodal involvement

Metastatic involvement

M0 - No metastases
M1 - Metastases present

Stage groupings of Lung Cancer

IA - T1N0M0
IB - T2N0M0
IIA - T1N1M0
IIB - T2N1M0 or T3N0M0
IIIA - T1-3N2M0 or T3N1M0
IIIB - Any T4 or any N3M0
IV - Any M1

References

↑ Mountain, CF (2003). A Handbook for Staging, Imaging, and Lymph Node Classification. Charles P Young Company. Retrieved 2007-09-01. Unknown parameter |coauthors= ignored (help)
↑ Collins, LG (Jan 2007). "Lung cancer: diagnosis and management". American Family Physician. American Academy of Family Physicians. 75 (1): 56–63. PMID 17225705. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)

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Template:WikiDoc Sources

[1] Mountain, CF (2003). A Handbook for Staging, Imaging, and Lymph Node Classification. Charles P Young Company. Retrieved 2007-09-01. Unknown parameter |coauthors= ignored (help)

[Collins-2] Collins, LG (Jan 2007). "Lung cancer: diagnosis and management". American Family Physician. American Academy of Family Physicians. 75 (1): 56–63. PMID 17225705. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)

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