J Korean Med Assoc.  2008 Dec;51(12):1118-1124. 10.5124/jkma.2008.51.12.1118.

Staging of Lung Cancer

Affiliations
  • 1Department of Diagnostic Radiology, Center for Lung cancer, National Cancer Center, Korea. radhykim@ncc.re.kr

Abstract

Accurate staging of lung cancers is important to determine the treatment options and the prognosis of patients with a lung cancer. TNM system revised in 1997 by American Joint Committee on Cancer and the Union Internationale Contre le Cancer is widely used in staging of the lung cancer. The TNM system is an expression of the anatomic extent of diseases and is based on the assessment of three components; extent of the primary tumor (T), regional lymph node metastasis (N), and distant metastasis (M). Non-invasive staging of lung cancers is based primarily on chest computed tomography (CT), and if available, on positron emission tomography (PET). Chest CT scanning is useful in providing anatomic details, but the accuracy of the chest CT scanning in differentiating benign from malignant lymph nodes in the mediastinum is poor. PET scanning has a much better sensitivity and specificity than chest CT scanning for mediastinal lymph node staging, and distant metastatic diseases can be detected by PET scanning. With either test, abnormal findings must be confirmed by a tissue biopsy to ensure accurate staging. Invasive techniques for biopsy of mediastinal lymph nodes or pathologic tissue include transbronchial needle aspiration, transesophageal fine needle aspiration, and surgery.

Keyword

Lung; Lung cancer; Neoplasm staging

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Dietary Sucrose
Humans
Joints
Lung
Lung Neoplasms
Lymph Nodes
Mediastinum
Needles
Neoplasm Metastasis
Neoplasm Staging
Positron-Emission Tomography
Prognosis
Sensitivity and Specificity
Thorax
Dietary Sucrose

Reference

1. Mountain C. Revisions in the International System for Staging Lung Cancer. Chest. 1997. 111:1710–1717.
Article
2. Silvestri GA, Tanoue LT, Margolis ML, Barker J, Detterbeck F. The noninvasive staging of non-small cell lung cancer: the guidelines. Chest. 2003. 123:147S–156S.
3. Rami-Porta R, Ball D, Crowley J, Giroux DJ, Jett J, Travis WD, Tsuboi M, Vallières E, Goldstraw P. International Staging Committee. Cancer Research and Biostatistics, Observers to the Committee, Participating Institutions. The IASLC Lung Cancer Staging Project: proposal for the revision of the T descriptors in the forth coming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007. 2:593–602.
Article
4. Rusch VW, Crowley J, Giroux DJ, Goldstraw P, Im JG, Tsuboi M, Tsuchiya R, Vansteenkiste J. International Staging Committee. Cancer Research and Biostatistics, Observers to the Committee, Participating Institutions. The IASLC Lung Cancer Staging Project: proposal for the revision of the N descriptors in the forth coming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007. 2:603–612.
Article
5. Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, von Schulthess GK, Steinert HC. Staging of non-small-cell lung cancer with integrated position-emission tomography and computed tomography. N Engl J Med. 2003. 348:2500–2507.
Article
6. Silvestri GA, Gould MK, Margolis ML, Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, von Schulthess GK, Steinert HC. Noninvasive staging of non-small cell lung cancer ACCP Evidence-based clinical practice guidelines, 2nd ed. Chest. 2007. 132:178S–201S.
7. MacDonald SL, Hansell DM. Staging of non-small cell lung cancer: imaging of intrathoracic disease. Eur J Radiol. 2003. 45:18–30.
Article
8. Weder W. Lung cancer: new opportunities-changing algorithm in staging. Ann Oncol. 2008. 19:28S–30S.
Article
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr