STAGING Lung Carcinoma
STAGING Lung Carcinoma
STAGING Lung Carcinoma
IJ
LUNG CARCINOMAS
Nonsmall cell lung cancer (NSCLC):
Most cases of lung cancer [adenocarcinoma,
squamous cell carcinoma, and large cell carcinoma ]
37.5% classified as adenocarcinoma
The most prevalent histology in both smokers and
nonsmokers
• Most patients with stage IIIB (except those with T4N0) and all of
those with stage IV disease are not considered for surgery
• Patients contraindications to surgery should be offered
radiation therapy (RT) with or without Chemotherapy
Radiology: 246:
2,2008
PRIMARY THERAPY FOR STAGE IA
TO IIB NSCLC
Ref…
IMAGING MODALITIES
1. Chest radiography .
2. Computed tomography (CT) .
3. Magnetic resonance (MR) imaging .
4. Positron emission tomography (PET)
5. Fused PET/CT .
• Necessary for
staging
• For surgical
treatment plan
• Important for
radiologists to
describe
primary tumor
in the reports.
T1
• Tumor < 3 cm,
surrounded by lung/
visceral pleura
1. T1a < 2 cm
2. T1b = 2-3 cm
• Without
bronchoscopic
evidence of
invasion more
proximal than the
lobar bronchus (not
in the main
bronchus)
T2
• Tumor 3-7 cm
1. T2a : Tumor 3-5 cm in
greatest dimension
2. T2b : Tumor 5-7 cm in
greatest dimension
man 35 yo
Larger than 3 cm largest dimension (5-7cm) T2b)
Man with adenocarcinoma right lower lung
Tumor > 7 cm or one that
directly invades any of
T3 the following:
NsClC
T4 Check dr fifi ?
International Association for the Study of Lung Cancer nodal chart with
station and zones. Left upper lobe to the subaortic and paraaortic (5 and 6)
Expert Rev. Respir. Med. 5(6), (2011)
N1-2 Mediastinal Nodes
LUNG CANCER
ENLARGED LYMPH NODES
IN THE RIGHT HILAR ..
(WHITE ARROW) N1
AND TRACHEOBRONCHIAL
(YELLOW ARROW)
REGIONS N 2
SUGESTING N1 AND N2
DISEASE
Cancer Imaging (2007) 7, 159
N 2 IPSILATERAL SUPERIOR
MEDIASTINAL NODES
(NODAL STATION 4R LOWER PARATRACHEA)
4R
Zone 5
Subaor
tic
Nodes
N2 MEDIASTINAL NODES
7 SUBKARINA NODES
N3 SUPRACLAVICULAR NODES
(NODAL STATION 1R STERNAL NOTCH NODES)
1
R