A cancer staging primer: Lung

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Presentation transcript:

A cancer staging primer: Lung Thomas W. Rice, MD, Sudish C. Murthy, MD, PhD, David P. Mason, MD, Eugene H. Blackstone, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 4, Pages 826-829 (April 2010) DOI: 10.1016/j.jtcvs.2009.11.010 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 T classification by size (greatest dimension). T1a, ≤2 cm; T1b, >2 to 3 cm; T2a, >3 to 5 cm; T2b, >5 to 7 cm; T3, diam. >7 cm. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Classification of satellite nodules: T3, in same lobe; T4, in a different ipsilateral lobe; and M1a, in contralateral lung. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 M1a cancer. Cancers associated with malignant pleural or pericardial effusion, malignant pleural nodules, or those with satellite nodules in contralateral lung (green). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 T2a cancer by local invasion. Invasion of visceral pleura (purple) or main airway ≥2 cm from the carina (red) or atelectasis or obstructive pneumonia extending to the hilum, but not involving the entire lung (yellow), elevates cancers otherwise classified as T1 to T2a. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 T3 cancer by local invasion: (1) invasion of parietal pleura or pericardium, chest wall, diaphragm, phrenic nerve, or mediastinal pleura (purple) or main airway <2 cm from the carina (red), without carinal involvement; (2) associated atelectasis or obstructive pneumonia of the entire lung (yellow); and (3) a satellite nodule in the same lobe (blue). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 T4 cancer: Invasion of the mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina (red), or satellite nodules in a different ipsilateral lobe (orange). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Lymph node map: Lymph node zones are supraclavicular (green), upper mediastinal (blue), aortopulmonary (gray), subcarinal (yellow), lower mediastinal (orange), hilar/interlobar (pink), and peripheral (aqua). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 8 Stage groupings for M0 lung cancers. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 826-829DOI: (10.1016/j.jtcvs.2009.11.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions