Superior vena cava syndrome staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]


According to the Journal of Thoracic Oncology, there are 5 stages of superior vena cava syndrome based on the severity and incidence. Each stage is assigned a grade and a description that designate disease severity.


The table below summarizes the different stages of superior vena cava syndrome, categorizing them according to clinical severity. [1][2]

Grade Category Incidence Definition
0 Asymptomatic 10 Radiographic superior vena cava obstruction in the absence of symptoms.
1 Mild 25 Edema in head or neck (vascular distention), cyanosis, and plethora.
2 Moderate 50 Edema in head or neck with functional impairment (mild dysphagia, cough, mild or moderate impairment of head, jaw or eyelid movements, and visual disturbances caused by ocular edema).
3 Severe 10 Mild or moderate cerebral edema (headache and dizziness) or mild/moderate laryngeal edema or diminished cardiac reserve (syncope after bending).
4 Life-threatening 5 Significant cerebral edema (confusion and obtundation) or significant laryngeal edema (stridor) or significant hemodynamic compromise (syncope without precipitating factors, hypotension, and renal insufficiency).
5 Fatal < 1 Death


  1. Yu JB, Wilson LD, Detterbeck FC (2008). "Superior vena cava syndrome--a proposed classification system and algorithm for management". J Thorac Oncol. 3 (8): 811–4. doi:10.1097/JTO.0b013e3181804791. PMID 18670297.
  2. Wilson LD, Detterbeck FC, Yahalom J (2007). "Clinical practice. Superior vena cava syndrome with malignant causes". N. Engl. J. Med. 356 (18): 1862–9. doi:10.1056/NEJMcp067190. PMID 17476012.