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Case History

image A reasonably fit 62-year-old smoker presents with persistent cough. Bronchoscopy reveals an obstructing endobronchial tumour in the right middle lobe bronchus, 1 cm from the subcarina. Biopsy confirms squamous cell carcinoma. A computed tomography (CT) staging scan shows collapse/consolidation in the right middle lobe distal to a 2.5 cm tumour and several 1.5–2 cm lymph nodes in the mediastinum in the N1 and N2 positions. No metastatic nodules are visualized within the other lobes of the lung, and there are no distant metastases.

What is the bronchoscopic and radiological stage of this tumour?

What are the implications for management?


What is the bronchoscopic and radiological stage of this tumour?

image Accurate staging in patients with non-small cell lung cancer (NSCLC) has a critical role in determining optimal therapy (Tables 32.1 and 32.2). It reflects the nature and extent of disease and provides important prognostic information. Surgery remains the treatment of choice for early-stage NSCLC, and the likelihood of curative surgery depends on the local extent of the primary tumour and presence of any distant metastases.1,2

Table 32.1TNM staging of non-small cell lung cancer

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