Lung Cancer.

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Presentation transcript:

Lung Cancer

Histologic Classification of Non-small Cell Lung Cancer Squamous cell (epidermoid) carcinoma spindle cell variant Adenocarcinoma acinar papillary bronchoalveolar solid tumor with mucin Large cell carcinoma giant cell clear cell Adenosquamous carcinoma Undifferentiated carcinoma

TNM Staging Stage TNM 5-year Survival O Carcinoma in situ 1A TIN0M0 67% 1B T2N0M0 57% IIA T1N1M0 55% IIB T2N1M0 T3N0M0 38% IIIA T3N1M0 T1N2M0 T2-3N2M0 23% IIIB T4N0-2 T1-4N3M0 5% IV T1-4N0-3M1 1% Survival is very heavily dependent upon TNM tumor stage Stages 1A through IIIB are dependent on the T and N classification Stage IV disease is defined by metastatic disease Major distinctions: Stage IIA and stage IIB Stage IIIA and stage IIIB

--Regional nodal stations for lung cancer staging Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782 Copyright © 2006 by the American Roentgen Ray Society

--Regional nodal stations for lung cancer staging Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782 Copyright © 2006 by the American Roentgen Ray Society

--Regional nodal stations for lung cancer staging Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782 Copyright © 2006 by the American Roentgen Ray Society

--Regional nodal stations for lung cancer staging Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782 Copyright © 2006 by the American Roentgen Ray Society

STAGE 0 TisN0M0 TREATMENT ENDOSCOPY SURGERY RADIATION

STAGE 1A T1N0M0 TREAMENT SURGERY RADIATION

STAGE 1B T2N0M0 TREATMENT SURGERY RADIATION

STAGE IIA T1N1M0 TREATMENT SURGERY RADIATION CHEMOTHERAPY

STAGE IIB T2N1M0 T3N0M0 TREATMENT SURGERY RADIATION CHEMOTHERAPY

STAGE IIIA T3N1M0 T1N2M0 T2-3N2M0 TREATMENT RADIATION CHEMOTHERAPY

STAGE IIIB T4N0-2M0 T1-4N3M0 TREATMENT RADIATION CHEMOTHERAPY

STAGE IV T1-4 N0-3M1 TREAMENT RADIATION CHEMOTHERAPY SURGERY

SPECIAL SITUATIONS Pancoast’s Tumor Medically Unfit Radiation Chemotherapy Surgery Medically Unfit Ablation Bronchial Obstruction Stent Laser Puotodynamic Therapy

SUMMARY Difficult disease to treat usually presents at late stage Best results when found early Screening though effective