Skip to Main Content

++

INTRODUCTION

++

Epidemiology

Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
Epidemiology
Incidence:

224,210 (male: 116,000; female: 108,210. Estimated new cases for 2014 in the United States)

61.4 per 100,000 male and female per year (74.3 per 100,000 men, 51.9 per 100,000 women)

Deaths: Estimated 159,260 in 2014 (male: 86,930; female: 72,330)
Median age: 61.4 years
Male-to-female ratio: ~1:1

 

Stage at Presentation

Localized (confined to primary site): 15%

Regional (spread to regional lymph nodes): 22%

Distant (cancer has metastasized): 57%

 

Siegel R et al. CA Cancer J Clin 2014;64:9–29

Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov (accessed in 2013)

Weir HK et al. J Natl Cancer Inst 2003;95:1276–1299

++

Pathology

Lung cancer is divided into 2 major classes:

Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print

1. Non–small cell lung cancer (NSCLC):

  • Squamous cell carcinoma

  • Adenocarcinoma

  • Large-cell carcinoma

75–85%

2. Small cell lung cancer (SCLC)

15–25%

Brambilla E et al. Eur Respir J 2001;18:1059–1068

++

NON–SMALL CELL LUNG CANCER (NSCLC)

++

Work-up

  1. History and physical examination including performance status and weight loss

  2. Chest x-ray, PA and lateral

  3. CT scan of chest and upper abdomen including adrenals

  4. CBC, serum electrolytes, BUN, creatinine, calcium, magnesium, and LFTs

  5. CT scan and/or MRI of brain if neurologic history or examination is abnormal

  6. Bone scan if there is bone pain, elevated calcium level, or elevated alkaline phosphatase level

  7. Assessment of perioperative risks for potential candidates for surgery, including pulmonary function tests (PFTs)

Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
Stages I-II

  1. Bronchoscopy

  2. FDG-PET scan

Stages IIIA-IIIB

  1. Bronchoscopy

  2. FDG-PET scan

  3. MRI of the chest in superior sulcus tumors

  4. MRI of brain

  5. Bone scan

  6. Mediastinal lymph node biopsy if CT scan shows nodes >1 cm

  Invasive tests: Mediastinoscopy, thoracoscopy, transbronchial needle aspiration, and endoscopic ultrasound and needle aspiration

Stage IV Biopsy for otherwise potentially resectable patient with isolated adrenal mass or liver lesion

++

Staging

Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
Staging

Primary Tumor (T)

...
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Tis Carcinoma in situ
T1 Tumor ≤3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (ie, not in the main bronchus)
T1a Tumor ≤2 cm in greatest dimension
T1b Tumor >2 cm but ≤3 cm in greatest dimension
T2

Tumor >3 cm but ≤7 cm or tumor with any of the following features (T2 tumors with these features are classified T2a if ≤5 cm)

Involves main bronchus, ≥2 cm distal to the carina

Invades visceral pleura (PL1 or PL2)

Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung

T2a Tumor >3 cm but ≤5 cm in greatest dimension
T2b Tumor >5 cm but ≤7 cm in greatest dimension
T3

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.