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Thoracic Surgery > Lung Cancer > Staging
Staging
There are two primary types of lung cancer. Small-cell lung cancer (SCLC), which comprises less than 20% of diagnosed lung cancer and Non-small-cell lung cancer (NSCLC), which make up the majority of all lung cancer.
Small-cell lung cancer is divided into two stages. Staging is classified as:
- Limited: the disease is confined to the chest
- Extensive: the disease has spread outside the chest
This type of cancer usually starts near the center of the chest, in the bronchi. It is significant because the small cells
multiply quickly and form tumors, which spread rapidly throughout the body. The treatment for small-cell lung cancer is
limited to chemotherapy and radiation therapy. Surgery is not the standard treatment option for small-cell lung cancer
because at the time of diagnosis it is generally wide spread throughout the body. This type of lung cancer is usually the
result of smoking cigarettes; it is very rare that a non-smoker would develop small-cell lung cancer.
Non-small-cell lung cancer (NSCLC) makes up the majority of lung cancer. This group is divided into the following
sub-types, which differ in size, shape and chemical make-up.
Squamous cell carcinoma - this type of NSCLC is often centrally located, occurring in the bronchi or surface cells
(squamous epithelium) of the lungs. Generally it is slow growing and may appear as inflammation of the lungs
(pneumonia) or collapsed portions of the lung (atelectasis).
Adenocarcimoa - this type of NSCLC is usually found on the outer edges of the lungs. It is a cancer of the glandular
tissue and generally appears as singular nodules, masses or scarring of the lung.
Large-cell carcinoma - this is a NSCLC is important for the determination of both prognosis (the outlook for the
chances of survival) and treatment.
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T (primary tumor); N (regional lymph nodes); and M (distant metastasis). |
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Staging is based on three components: T (primary tumor);
N (regional lymph nodes); and M (distant metastasis). |
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Regional lymph node stations for lung cancer
staging [22]. There are 14 numbered stations
to define mediastinal (N2), hilar (N1), and
intrapulmonary lymph nodes (N1). The
American Joint Committee on Cancer (AJCC)
approved this lymph node map. Identifying the
location of affected lymph nodes is important in
determining which patients are candidates for
potential curative resection as well as in
predicting prognosis.
(Adapted from Mountain [22].)
References:
[22]. Mountain C, Dresler C, Regional lymph node classification
for lung cancer staging. Chest 1997 111 1718-1723 |
References:
- American Cancer Society. Cancer Facts and Figures (2005). www.cancer.org
- National Center for Chronic Disease Prevention and Health Promotion. Cancer Prevention and Control. *Last accessed March 2005.
www.cdc.gov/cancer/lung
- Toloza E, Harpole L, McCrory D. Noninvasive Staging of Non-Small Cell Lung Cancer. Chest 2003; 123:137S-146S.
- Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest 1997; 111(6): 1710-7.
- Ginsberg RJ. Invasive and noninvasive techniques of staging in potentially operable lung cancer. Semin Surg Oncol 1990; 6(5): 244-7.
- Mountain CF, Dresler CM. Regional Lymph Node Classification for Lung Cancer Staging.Chest 1997; 111(6): 1718-23.
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