Lung Cancer.pdf

Implementation of Multidisciplinary Care 11
Table 1–3. Brief Description of the Stage Groupings for Lung Cancer
Stage 0 Carcinoma in situ
Stage IA T1 N0 M0
Stage IB T2 N0 M0
Stage IIA T1 N1 M0
Stage IIB T2 N1 M0
T3 N0 M0
Stage IIIA T3 N1 M0
T1 N2 M0
T2 N2 M0
T3 N2 M0
Stage IIIB T4 N0 M0
T4 N1 M0
T4 N2 M0
T1 N3 M0
T2 N3 M0
T3 N3 M0
T4 N3 M0
Stage IV Any T Any N M1
Reprinted with permission from Mountain CF. Revisions in the International System for
Staging Lung Cancer. Chest 1997;111:1710–1717.
lated to metastases) and to the cervical and supraclavicular lymph nodes.
Enlarged cervical or supraclavicular lymph nodes may be the first clues to
extrathoracic nodal metastasis (N3 disease), the presence of which suggests
treatment with nonsurgical means (chemotherapy, radiation therapy,
or both).
The evaluation of performance status includes evaluation of cardiac
function, pulmonary function, exercise tolerance, and associated comorbid
conditions that will influence the patient’s subsequent therapy.
Chest Radiography and Computed Tomography
of the Chest and Upper Abdomen
Chest radiography and CT of the chest and upper abdomen (including the
adrenal glands) are performed in all patients.
Chest radiography provides information on the size, shape, and density
of the tumor and its location with respect to the mediastinal structures.
Chest radiography also provides information about the presence of
thoracic lymphadenopathy, pleural effusion, pericardial effusion, pulmonary
infiltrates, pneumonia, and consolidation. Changes in the contour
of the mediastinum secondary to lymphadenopathy and metastasis
to ribs or other bone structures may be visualized. Chest radiography