Large cell carcinoma of the lung staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Staging system classification for large cell carcinoma of the lung is same as the non-small cell lung cancer staging. The two main staging systems, include: American Joint Committee on Cancer (AJCC) staging system and International Union Against Cancer (UICC) staging system. According to both institutions, TNM system, which they now develop jointly, classifies cancer by several factors, T for tumor, N for nodes, M for metastasis, and then groups these TNM factors into overall stages.

Staging

  • Staging system classifications for large cell carcinoma of the lung cancer, include:[1][2]
  • American Joint Committee on Cancer (AJCC) staging system
  • International Union Against Cancer (UICC) staging system

American Joint Committee on Cancer (AJCC) Staging

  • The table below summarizes the TNM staging system for the diagnosis of large cell carcinoma of the lung[2]
TNM Description
TX The primary tumour cannot be assessed, or there are malignant cells in the sputum or bronchoalveolar lavage but not seen on imaging or bronchoscopy
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1 Tumour less than 3 cm in its greatest dimension, surrounded by lung or visceral pleura and without bronchoscopic invasion into the main bronchus.
T2 A tumour with any of: More than 3 cm in greatest dimension; Extending into the main bronchus, but more than 2 cm distal to the carina; Obstructive pneumonitis, but not involving the entire lung
T3 A tumour with any of: Invasion of the chest wall, diaphragm, mediastinal pleura, or parietal pericardium; Extending into the main bronchus, within 2 cm of the carina, but not involving the carina; Obstructive pneumonitis of the entire lung
T4 A tumour with any of: Invasion of the mediastinum, heart, great vessels, trachea, oesophagus, vertebra, or carina; Separate tumour nodules in the same lobe; Malignant pleural effusion
Regional Lymph Nodes
NX Lymph nodes cannot be assessed
N0 No lymph nodes involved
N1 Metastasis to ipsilateral peribronchial or ipsilateral hilar lymph nodes
N2 Metastasis to ipsilateral mediastinal or subcarinal lymph nodes
N3 Metastasis to any of: Ipsilateral supraclavicular lymph nodes; Ipsilateral scalene lymph nodes; Contralateral lymph nodes.
Distant Metastasis
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis is present

International Union Against Cancer (UICC) Staging System

  • The table below summarizes the TNM staging system for the diagnosis of large cell carcinoma of the lung[2]
Stage T N M
Occult carcinoma TX N0 M0
Stage 0 Tis N0 M0
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 T1 N2 M0
T2 N2 M0
T3 N1 M0
T3 N2 M0
Stage IIIB Any T N3 M0
T4 Any N M0
Stage IV Any T Any N M1

References

  1. Horn, Leora, et al. "Neoplasms of the Lung." Harrison's Principles of Internal Medicine, 19e. Eds. Dennis Kasper, et al. New York, NY: McGraw-Hill, 2015. n. pag. AccessMedicine. Web. 1 Mar. 2016. <http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=1130&Sectionid=69857702>.
  2. 2.0 2.1 2.2 Stages of non–small cell lung cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/lung/staging/?region=ab

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