December 30, 2009

2009 Non-Small Cell Lung Cancer Staging System (3)

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As a radiologist, it may be easier to memorize "T" classification based on imaging appearance. The scheme below may be used as a guidance to stage these tumors, however a full text of the New Staging System should be reviewed for comprehensiveness.
  1. Peripheral mass abutting chest wall or diaphragm --- see if there is evidence of invasion of chest wall or diaphragm (T3)
  2. Peripheral mass, distal to lobar bronchus, completely surrounded by lung --- measuring size (less than 3cm = T1, 3-7cm = T2, more than 7cm = T3)
  3. Mass distal to 2 cm from the carina but proximal to lobar bronchus --- T2 by definition
  4. Endobronchial mass: distal to 2 cm from the carina = T2; within 2 cm from the carina = T3
  5. Central mass with postobstructive pneumonitis or atelectasis: lobar or segmental = T2;entire lung = T3
  6. Central mass abutting the mediastinum: invade mediastinal pleura, parietal pericardium = T3; diaphramatic paralysis (phrenic nerve involvement) = T3; invade heart, great vessels, trachea, esophagus, carina, vertebral body = T4
  7. Additional malignant lung nodules: same lobe = T3; ipsilateral different lobe = T4; contralateral = M1a
  8. Malignant pleural effusion or pleural nodule = M1a
Detterbeck FC, Boffa DJ, Tanoue LT. The new lung cancer staging system. Chest 2009:136;260-271.

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1 comment:

Non-small cell lung cancer said...

Non-small cell lung cancer is a cluster or group of different cancers of the lungs. This is very common variety of lung cancer, it is spreading widely. Smoking is said to be the main cause of this cancer. Its subtypes are: Squamous cell carcinoma, Large cell carcinoma, Adenocarcinoma.

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