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Difference between revisions of "Lung cancer staging"
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The article deals with '''lung cancer staging'''. A general discussion | The article deals with '''lung cancer staging'''. A general discussion about staging is found in ''[[cancer staging]]''. | ||
==General== | ==General== | ||
| Line 7: | Line 7: | ||
===Tumour=== | ===Tumour=== | ||
AJCC 7th edition:<ref>{{Ref AJCC7HB|316}}</ref> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
!T stage | !T stage | ||
| Line 25: | Line 26: | ||
| T1a | | T1a | ||
| <=2 cm | | <=2 cm | ||
| confined to lung, no [[VPI]], no main branch bronchus involvement | | confined to lung, no [[visceral pleural invasion|visceral pleural invasion (VPI)]], no main branch bronchus involvement | ||
| | | | ||
|- | |- | ||
| Line 39: | Line 40: | ||
|- | |- | ||
| T2b | | T2b | ||
| >5cm | | >5cm, < 7cm | ||
| confined to lung, no total lung collapse | | confined to lung, no total lung collapse | ||
| | | may have VPI ''and/or'' main branch bronchus involvement | ||
|- | |- | ||
| T3 | | T3 | ||
| >7 cm ''or'' | | >7 cm ''or'' total lung collapse ''or'' presence of two or more tumour nodules in same lobe ''or'' minor extension beyond lung | ||
| | | ''minor extension beyond lung'' includes any of the following: parietal plural of chest wall or mediastinal pleura, diaphragm, phrenic nerve, parietal pericardium | ||
| | | ipsilateral tumour nodule(s) in a ''different'' lobe is T4 | ||
|- | |- | ||
| T4 | | T4 | ||
| extension beyond the lung | | major extension beyond the lung ''or'' separate lesions in others lobes on the ipsilateral side | ||
| | | ''major extension beyond the lung'' includes any of the following: carina, trachea, esophagus, recurrent laryngeal nerve, mediastinum, heart, great vessels, vertebral body | ||
| | | separate lesions on the contralateral side are M1a<ref>{{Ref AJCC7HB|317}}</ref> | ||
|} | |} | ||
===Lymph nodes=== | ===Lymph nodes=== | ||
AJCC 7th edition: | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
!N stage | !N stage | ||
| Line 74: | Line 76: | ||
| N3 | | N3 | ||
| metastasis in any contralateral node, scalene node or supraclavicular node | | metastasis in any contralateral node, scalene node or supraclavicular node | ||
| | |||
|} | |||
====Lymph nodes stations==== | |||
{| class="wikitable sortable" | |||
! Station number | |||
! Location | |||
! N Staging ‡ | |||
|- | |||
| Station 1 | |||
| lower cervical, supraclavicular, sternal notch | |||
| N3 for supraclavicular,<ref name=pmid23543202>{{Cite journal | last1 = Riquet | first1 = M. | last2 = Mordant | first2 = P. | last3 = Fabre-Guillevin | first3 = E. | last4 = Arame | first4 = A. | last5 = Foucault | first5 = C. | last6 = Dujon | first6 = A. | last7 = Le Pimpec Barthes | first7 = F. | title = Long-term survival with surgery as part of a multimodality approach for N3 lung cancer. | journal = Eur J Cardiothorac Surg | volume = 44 | issue = 6 | pages = 1117-22 | month = Dec | year = 2013 | doi = 10.1093/ejcts/ezt171 | PMID = 23543202 }}</ref><br> N2 for others | |||
|- | |||
| Station 2 | |||
| upper paratracheal nodes (left and right) | |||
| N2 | |||
|- | |||
| Station 3 | |||
| prevascular (anterior) and retrotracheal (posterior) | |||
| N2 | |||
|- | |||
| Station 4 | |||
| lower paratracheal (right and left) | |||
| N2 | |||
|- | |||
| Station 5 | |||
| subaortic/aorto-pulmonary window | |||
| N2 | |||
|- | |||
| Station 6 | |||
| para-aortic (phrenic or asc. aorta) | |||
| N2 | |||
|- | |||
| Station 7 | |||
| subcarinal | |||
| N2 | |||
|- | |||
| Station 8 | |||
| paraesophageal | |||
| N2 | |||
|- | |||
| Station 9 | |||
| pulmonary ligament | |||
| N2 | |||
|- | |||
| Station 10 | |||
| hilar nodes (left and right) | |||
| N1 | |||
|- | |||
| Station 11 | |||
| interlobar nodes (left and right) | |||
| N1 | |||
|- | |||
| Station 12 | |||
| lobar (left and right) | |||
| N1 | |||
|- | |||
| Station 13 | |||
| segmental (left and right) | |||
| N1 | |||
|- | |||
| Station 14 | |||
| subsegmental (left and right) | |||
| N1 | |||
|} | |||
Note: | |||
*‡ Contralateral lymph node involvement is ''N3''.<ref name=pmid24624287>{{Cite journal | last1 = Terán | first1 = MD. | last2 = Brock | first2 = MV. | title = Staging lymph node metastases from lung cancer in the mediastinum. | journal = J Thorac Dis | volume = 6 | issue = 3 | pages = 230-6 | month = Mar | year = 2014 | doi = 10.3978/j.issn.2072-1439.2013.12.18 | PMID = 24624287 }}</ref> | |||
===Metastases=== | |||
AJCC 7th edition: | |||
{| class="wikitable sortable" | |||
!M stage | |||
!Criteria | |||
!Comment | |||
|- | |||
| M1a | |||
| nodule in contralateral lung ''or'' malignant pleural effusion ''or'' malignant pericardial effusion | |||
| malignant effusion in a previous edition were pT4<ref>{{Ref AJCC7HB|299}}</ref> | |||
|- | |||
| M1b | |||
| distant metastasis (extrathoracic organs) | |||
| | | | ||
|} | |} | ||
| Line 79: | Line 163: | ||
==See also== | ==See also== | ||
*[[Lung tumours]]. | *[[Lung tumours]]. | ||
*[[Lung adenocarcinoma]]. | |||
*[[Lung squamous cell carcinoma]]. | |||
==References== | ==References== | ||