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:

• 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

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

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