Seventh Edition of the Cancer Staging Manual and Stage Grouping of Lung Cancer. Quick Reference Chart and Diagrams
|
|
- Rosalind Rice
- 5 years ago
- Views:
Transcription
1 CHEST Special Features Seventh Edition of the Cancer Staging Manual and Stage Grouping of Lung Cancer Quick Reference Chart and Diagrams Omar Lababede, MD ; Moulay Meziane, MD ; and Thomas Rice, MD, FCCP Lung cancer remains the most common cause of cancer-related death in the United States. TNM staging, which is an important guide to the prognosis and treatment of lung cancer, has been revised recently. In this article, we propose a quick reference chart and diagrams that consolidate TNM staging information in a simple format. The current classification of lymph node stations and zones is illustrated as well. CHEST 2011; 139(1): Abbreviations: M 5 metastases; N 5 regional lymph node involvement; T 5 primary tumor Lung cancer is the leading cause of cancer mortality in both men and women in the United States. 1 Staging plays a critical role in guiding treatment selection and determining prognosis of cancer. Additionally, the evaluation of the response to treatment and the clinical research of cancer are facilitated by a universal system. TNM staging provides a consistent, reproducible description of cancers based on the extent of anatomic involvement. This is achieved by defining the characteristics of the primary tumor (T), regional lymph node involvement (N), and metastases (M). The seventh edition of TNM staging for lung tumors has been released recently. The revisions in the new edition were recommended by the International Association for the Study of Lung Cancer staging project and were accepted by both the International Union Against Cancer and the American Joint Committee on Cancer. 2-6 TNM staging of lung cancer is complex, and many variables must be considered ( Tables 1, 2 ). It can be Manuscript received April 27, 2010; revision accepted June 14, Affiliations: From the Imaging Institute (Drs Lababede and Meziane) and the Department of Thoracic and Cardiovascular Surgery (Dr Rice), Cleveland Clinic, Cleveland, OH. Correspondence to: Omar Lababede, MD, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195; lababeo@ccf.org 2011 American College of Chest Physicians. Reproduction of this article is prohibited without written permission from the American College of Chest Physicians ( site/misc/reprints.xhtml ). DOI: /chest difficult to use and remember. We have designed a chart and two diagrams to present the new staging system in a simple, but nevertheless comprehensive, format. The comparative characteristics of the primary tumor are listed in the vertical columns of the chart ( Fig 1 ). These features include size and extent (endobronchial location, local invasion, and satellite nodule[s]). The horizontal columns describe regional lymph node involvement. The different stage groupings are color coded and can be found at the intersections of appropriately matched horizontal and vertical columns. Stages with unique characteristics such as stages 0 and IV are defined in separate boxes. The basic design of the chart is based on our previously published reference chart of the fifth edition of lung cancer staging. 7 The diagrams ( Fig 2 ) illustrate the same information in a more concise visual format. The recently adopted revisions of TNM staging are reflected in our chart and diagrams. These changes include the following: TNM system application to small cell lung carcinoma and carcinoid tumor of the lung (the previous system was applicable to non-small cell lung carcinoma only) Redefinition of the primary tumor classification based on size: T1 is subdivided into T1a and T1b T2 is subdivided into T2a and T2b Cancer larger than 7 cm is reclassified as T3. CHEST / 139 / 1 / JANUARY,
2 Table 1 Seventh Edition of TNM Staging of Lung Tumors: Definition of T, N, and M 2-6 Descriptor Definition Primary tumor (T) Tx Tumor that cannot be assessed or is not detected radiologically or bronchoscopically but is proven histopathologically (malignant cells in bronchopulmonary secretions) T0 No evidence of primary tumor Tis Carcinoma in situ T1 Tumor with the following characteristics: Size 3 cm Airway location: in lobar bronchus or more distal airways Local invasion: none, surrounded by lung or visceral pleura Subdivisions: T1a (size 2 cm) and T1b (2 cm, size 3 cm) T2 Tumor with size. 3 cm but 7 cm or tumor with any of the following characteristics: Airway location: involvement of the main bronchus (distance to the carina is 2 cm) or presence of atelectasis or obstructive pneumonitis that extends to hilar region but does not involve the entire lung Local invasion: involvement of visceral pleura Subdivisions: T2a (3 cm, size 5 cm) and T2b (5 cm, size 7 cm) T3 Tumor. 7 cm in size or tumor with any of the following: Airway location: tumor in the main bronchus (within 2 cm of the carina), or tumor with atelectasis or obstructive pneumonitis of the entire lung Local invasion: direct invasion of chest wall (including superior sulcus tumors), diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium Satellite tumor nodule(s) in the same lobe as the primary tumor T4 Tumor of any size invading any of the following: mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina; or tumor with satellite tumor nodule(s) in a different lobe, ipsilateral to that of the primary tumor Lymph nodes (N) Nx Regional lymph nodes cannot be assessed N0 Absence of regional lymph node involvement N1 Presence of metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes (including direct extension to intrapulmonary nodes) N2 Presence of metastasis to ipsilateral mediastinal and/or subcarinal lymph nodes N3 Presence of metastasis to any of the following lymph node groups: contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes Distant metastasis (M) M0 Absence of distant metastasis M1 Presence of distant metastasis Subdivisions: M1a (satellite tumor nodule(s) in a contralateral lobe to that of the primary tumor or tumors with malignant pleural or pericardial effusion) M1b (distant metastasis) The uncommon superficial spreading tumor of any size with its invasive component limited to the bronchial wall is classified as T1a even in the case of extension to main bronchus. Satellite nodule(s) in the same lobe as the primary tumor will now classify the tumor as T3 (previously T4), whereas their presence in a different lobe of the same lung is reclassified as T4 (previously M1). Table 2 Seventh Edition of TNM Staging of Lung Tumors: Stage Grouping 2-6 Occult carcinoma (TxN0M0) Stage 0 (TisN0M0) Stage IA (T1a/bN0M0) Stage IB (T2aN0M0) Stage IIA (T1a/bN1M0, T2aN1M0,T2bN0M0) Stage IIB (T2bN1M0, T3N0M0) Stage IIIA (T(1-3)N2M0, T3N1M0, T4N(0-1)M0) Stage IIIB (T4N2M0, T(1-4)N3M0) Stage IV (Any T, any N, M1) Redefinition of metastases (M): subdivision of M into M1a and M1b. M1a includes both satellite nodule(s) in the contralateral lung and malignant pleural and pericardial effusions. Malignant pleural and pericardial effusions were classified previously as T4 N0 Mx. Changes to stage groupings, including T4N0M0 and T4N1M0 tumors are reassigned from stage IIIB to stage IIIA. The newly defined T2b tumors with no lymph node or distant metastases (T2bN0M0) are grouped under IIA instead of IB. The newly defined T2a tumors with N1 lymph node but without distant metastases (T2aN1M0) are grouped under IIA rather than IIB. 184 Special Features
3 Figure 1. Reference chart for 2009 TNM staging system of lung cancer. M 5 metastases; N 5 regional lymph node involvement; T 5 tumor. Although regional lymph node (N) classifications have not changed, a unified map of lymph node stations was adopted by the International Association for the Study of Lung Cancer. 2,3,8 The new map reconciles discrepancies among previous nodal mapping proposals and introduces the concept of lymph node zones ( Table 3 ). Figures 3A and 3B demonstrate the new lymph nodes stations. CHEST / 139 / 1 / JANUARY,
4 Figure 2. Reference diagrams for 2009 TNM staging system of lung cancer. The T classification can be defined by evaluating the size first (upper left), then upgrading the classification (if necessary) based on the presence of the other criteria of primary tumor invasion/extent (A, B, and C). The criteria of extent should not be used to assign a lower classification. The lower diagram can be used to define the N and M classification and to determine the corresponding stage. Note that N1, N2, N3, and the separate tumor nodule of M1a were depicted in the lower illustration based on a right-sided tumor (T). For left lung tumors, a mirror image of these descriptors should be used. Additionally, the endobronchial extension and local invasion (A and B of the criteria of extent) were shown in the upper illustration based on a left-sided tumor to simplify the drawing. See Figure 1 legend for expansion of abbreviations. 186 Special Features
5 Table 3 IASLC Lymph Node Definition 2,3,8 Definition Nodal Zone Nodal Station Nodes Description Upper Border Lower Border Other Supraclavicular 1 (R and L) Low cervical, supraclavicular and sternal notch Upper mediastinal 2R 2L Right upper Left upper Lower margin of cricoid cartilage Apex of right lung and pleural cavity and upper border of the manubrium Apex of left lung and pleural cavity and upper border of the manubrium Clavicles and upper border of the manubrium Intersection of caudal margin of the innominate vein and trachea Upper limits of the aortic arch Midline of the trachea defines R and L Left lateral margin of the trachea defines R and L 3a Prevascular Apex of chest Level of carina a 3p Retrotracheal Apex of chest Level of carina... 4R Right lower Intersection of caudal margin of the innominate vein and trachea Lower border of the azygos vein Left lateral margin of the trachea defines R and L 4L Left lower Upper limits of the aortic arch Upper rim of the left main pulmonary artery Aortopulmonary 5 Subaortic (aortopulmonary window) 6 Paraaortic (ascending aorta or phrenic) Lower border of the aortic arch Upper rim of the left main pulmonary artery Line tangential to the upper limits of the aortic arch Lower border of the aortic arch Subcarinal 7 Subcarinal The carina Upper border of lower lobe bronchus on the left and lower border of the bronchus intermedius on the right Lower mediastinal 8 (R and L) Paraesophageal Upper border of lower lobe bronchus on the left and lower border of the bronchus intermedius on the right Diaphragm Lateral to ligamentum arteriosum The midline defines R and L 9 (R and L) Pulmonary ligaments The inferior pulmonary vein Diaphragm Within the pulmonary ligament Hilar/interlobar 10 (R and L) Hilar Lower rim of the azygos on the right and upper rim of the left main pulmonary artery on the left Interlobar regions b 11 (R and L) Interlobar Between the origin of the lobar bronchi c Peripheral 12 (R and L) Lobar Adjacent to the lobar bronchi 13 (R and L) Segmental Adjacent to the segmental bronchi 14 (R and L) Subsegmental Adjacent to the subsegmental bronchi IASLC 5 International Association for the Study of Lung Cancer; L 5 left; R 5 right. a The posterior sternum forms the anterior border of the prevascular nodes, whereas the posterior border is limited by the anterior border of the superior vena cava on the right side and the left carotid artery on the left side. b Includes nodes adjacent to the main stem bronchi and hilar vessels, including the proximal aspects of the pulmonary arteries and veins. c Can be subdivided on the right into 11s (between the right upper lobe and bronchus intermedius) and 11i (between the middle and lower lobe bronchi). CHEST / 139 / 1 / JANUARY,
6 Figure 3. The International Association for the Study of Lung Cancer lymph node map depicted on views of the chest. A, right lateral view. B, left lateral view. The lymph node stations are color coded and grouped into zones. The colored arrows define the anatomic limits of certain color-matching stations. AA 5 aortic arch; AAo 5 ascending aorta; Ao 5 aorta; AzV 5 azygos vein; BI 5 bronchus intermedius; C 5 carina; E 5 esophagus; IPV 5 inferior pulmonary vein; IV 5 innominate vein; L 5 left; LLLB 5 left lower lobe bronchus; LPA 5 left main pulmonary artery; PA 5 main pulmonary artery; PUL. LIG. 5 pulmonary ligament; R 5 right; RLLB 5 right lower lobe bronchus; SVC 5 superior vena cava; T 5 trachea. 2,3,8 188 Special Features DownloadedFrom:htp:/journal.publications.chestnet.org/byaLoyolaUniversityMedicalCenterUseron08/08/2012
7 Acknowledgments Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. References 1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, CA Cancer J Clin ;59(4): Goldstraw P, ed. International Association for the Study of Lung Cancer Staging Manual in Thoracic Oncology. 1st ed. Orange Park, FL: Editorial Rx Press; Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A III, eds. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; Goldstraw P. The 7th rdition of TNM in lung cancer: what now? J Thorac Oncol ;4(6): Figure 3. Continued. 5. Detterbeck FC, Boffa DJ, Tanoue LT. The new lung cancer staging system. Chest ;136 (1 ): Goldstraw P, Crowley J, Chansky K, et al ; International Association for the Study of Lung Cancer International Staging Committee ; Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol ;2 (8 ): Lababede O, Meziane MA, Rice TW. TNM staging of lung cancer: a quick reference chart. Chest ;115 (1 ): Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P ; Members of IASLC Staging Committee. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol ;4 (5 ): CHEST / 139 / 1 / JANUARY,
The 8th Edition Lung Cancer Stage Classification
The 8th Edition Lung Cancer Stage Classification Elwyn Cabebe, M.D. Medical Oncology, Hematology, and Hospice and Palliative Care Valley Medical Oncology Consultants Director of Quality, Medical Oncology
More informationInternational Association for the Study of Lung Cancer lymph node map Lymph node stations Imaging CT
Review of the International Association for the Study of Lung Cancer Lymph Node Classification System Localization of Lymph Node Stations on CT Imaging Hamza Jawad, MBBS a, Arlene Sirajuddin, MD b, Jonathan
More informationAn Update: Lung Cancer
An Update: Lung Cancer Andy Barlow Consultant in Respiratory Medicine Lead Clinician for Lung Cancer (West Herts Hospitals NHS Trust) Lead for EBUS-Harefield Hospital (RB&HFT) Summary Lung cancer epidemiology
More informationCollaborative Stage. Site-Specific Instructions - LUNG
Slide 1 Collaborative Stage Site-Specific Instructions - LUNG In this presentation, we are going to review the AJCC Cancer Staging criteria for the lung primary site. Slide 2 Reading Assignments As each
More informationThe International Association for the Study of Lung Cancer Lymph Node Map: A Radiologic Atlas and Review
REVIEW http://dx.doi.org/10.4046/trd.2015.78.3.180 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2015;78:180-189 The International Association for the Study of Lung Cancer Lymph Node Map:
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationAJCC-NCRA Education Needs Assessment Results
AJCC-NCRA Education Needs Assessment Results Donna M. Gress, RHIT, CTR Survey Tool 1 Survey Development, Delivery, Analysis THANKS to NCRA for the following work Developed survey with input from partners
More informationImaging of Lung Cancer: A Review of the 8 th TNM Staging System
Imaging of Lung Cancer: A Review of the 8 th TNM Staging System Travis S Henry, MD Associate Professor of Clinical Radiology Cardiac and Pulmonary Imaging Section University of California, San Francisco
More informationONLINE CONTINUING EDUCATION ACTIVITY
ONLINE CONTINUING EDUCATION ACTIVITY Take free quizzes online at acsjournals.com/ce ARTICLE TITLE: Lung Cancer Major Changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer
THIS DOCUMENT IS North of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer [Based on WOSCAN NSCLC CMG with further extensive consultation within NOSCAN] UNCONTROLLED
More informationACRIN NLST 6654 Primary Lung Cancer. F1/F2 Interval: to (mm-dd-yyyy) 1. Date of diagnosis: (mm-dd-yyyy)
No. F1/F2 Interval: - - 20 to - - 20 (mm-dd-yyyy) 1. Date of diagnosis: - - 20 (mm-dd-yyyy) 2. Samples recorded: ZP Number S-Number 1) 2) 3) 4) (Refer to Form PX, Column 1. In the rare instance of a diagnosis
More informationABSTRACT. Journal of Radiation Research, Vol. 58, No. 1, 2017, pp doi: /jrr/rrw076 Advance Access Publication: 8 September 2016
Journal of Radiation Research, Vol. 58, No. 1, 2017, pp. 86 105 doi: 10.1093/jrr/rrw076 Advance Access Publication: 8 September 2016 The Japan Lung Cancer Society Japanese Society for Radiation Oncology
More informationCT Depiction of Regional Nodal Stations for Lung Cancer Staging
ownloaded from www.ajronline.org by 37.44.204.189 on 11/24/17 from IP address 37.44.204.189. opyright RRS. For personal use only; all rights reserved T epiction of Regional Nodal Stations for Lung ancer
More informationSlide 1. Slide 2. Slide 3. Investigation and management of lung cancer Robert Rintoul. Epidemiology. Risk factors/aetiology
Slide 1 Investigation and management of lung cancer Robert Rintoul Department of Thoracic Oncology Papworth Hospital Slide 2 Epidemiology Second most common cancer in the UK (after breast). 38 000 new
More information6 th Reprint Handbook Pages AJCC 7 th Edition
6 th Reprint Handbook Pages AJCC 7 th Edition AJCC 7 th Edition Errata for 6 th Reprint Table 1 Handbook No Significant Staging Clarifications for 6 th Reprint AJCC 7 th Edition Errata for 6 th Reprint
More informationGUIDELINES FOR CANCER IMAGING Lung Cancer
GUIDELINES FOR CANCER IMAGING Lung Cancer Greater Manchester and Cheshire Cancer Network Cancer Imaging Cross-Cutting Group April 2010 1 INTRODUCTION This document is intended as a ready reference for
More informationB REAST STAGING FORM. PATHOLOGIC Extent of disease through completion of definitive surgery. CLINICAL Extent of disease before any treatment
B REAST STAGING FORM CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery (DCIS) (LCIS) (Paget s) mi c a b c d TUMOR SIZE:
More informationB REAST STAGING FORM. PATHOLOGIC Extent of disease through completion of definitive surgery. CLINICAL Extent of disease before any treatment
B REAST STAGING FORM Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery (DCIS) (LCIS) (Paget s) mi a b c a b c d TUMOR SIZE: S TAGE
More informationDESCRIPTION: This is the part of the trunk, which is located between the root of the neck and the superior border of the abdominal region.
1 THE THORACIC REGION DESCRIPTION: This is the part of the trunk, which is located between the root of the neck and the superior border of the abdominal region. SHAPE : T It has the shape of a truncated
More informationThe tumor-node-metastasis (TNM) system is
LUNG CARCINOMA STAGING PROBLEMS Philip T. Cagle, MD a,b, * KEYWORDS Lung Carcinoma Staging Tumor-node-metastasis TNM system ABSTRACT The tumor-node-metastasis (TNM) system is the most commonly used staging
More informationMediastinal Staging. Samer Kanaan, M.D.
Mediastinal Staging Samer Kanaan, M.D. Overview Importance of accurate nodal staging Accuracy of radiographic staging Mediastinoscopy EUS EBUS Staging TNM Definitions T Stage Size of the Primary Tumor
More informationLung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09
Lung Cancer Imaging Terence Z. Wong, MD,PhD Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Acknowledgements Edward F. Patz, Jr., MD Jenny Hoang, MD Ellen L. Jones, MD, PhD Lung
More informationLecturer: Ms DS Pillay ROOM 2P24 25 February 2013
Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013 Thoracic Wall Consists of thoracic cage Muscle Fascia Thoracic Cavity 3 Compartments of the Thorax (Great Vessels) (Heart) Superior thoracic aperture
More informationLUNG STAGING FORM LATERALITY: LEFT RIGHT BILATERAL
LUNG STAGING FORM LATERALITY: LEFT RIGHT BILATERAL ( ) Tx Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging
More informationLung 8/7/14. Collecting Cancer Data: Lung NAACCR Webinar Series. August 7, 2014
Collecting Cancer Data: Lung 2013 2014 NAACCR Webinar Series August 7, 2014 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching
More informationDr. Weyrich G07: Superior and Posterior Mediastina. Reading: 1. Gray s Anatomy for Students, chapter 3
Dr. Weyrich G07: Superior and Posterior Mediastina Reading: 1. Gray s Anatomy for Students, chapter 3 Objectives: 1. Subdivisions of mediastinum 2. Structures in Superior mediastinum 3. Structures in Posterior
More informationLarge veins of the thorax Brachiocephalic veins
Large veins of the thorax Brachiocephalic veins Right brachiocephalic vein: formed at the root of the neck by the union of the right subclavian & the right internal jugular veins. Left brachiocephalic
More informationCase Conference: Post-Operative Radiotherapy for Non-Small Cell Lung Cancer. Doug Rahn 6/1/12
Case Conference: Post-Operative Radiotherapy for Non-Small Cell Lung Cancer Doug Rahn 6/1/12 Outline I. Presentation of Case II. Epidemiology III. Staging IV. Review of Literature V. Recommendations VI.
More informationMediastinum It is a thick movable partition between the two pleural sacs & lungs. It contains all the structures which lie
Dr Jamila EL medany OBJECTIVES At the end of the lecture, students should be able to: Define the Mediastinum. Differentiate between the divisions of the mediastinum. List the boundaries and contents of
More informationThe IASLC Lung Cancer Staging Project
IASLC STAGING COMMITTEE ARTICLE A Proposal for a New International Lymph Node Map in the Forthcoming Seventh Edition of the TNM Classification for Lung Cancer Valerie W. Rusch, MD,* Hisao Asamura, MD,
More informationslide 23 The lobes in the right and left lungs are divided into segments,which called bronchopulmonary segments
Done By : Rahmeh Alsukkar Date : 26 /10/2017 slide 23 The lobes in the right and left lungs are divided into segments,which called bronchopulmonary segments Each segmental bronchus passes to a structurally
More informationRevisiting Stage IIIB and IV Non-small Cell Lung Cancer. Analysis of the Surveillance, Epidemiology, and End Results Data
CHEST Revisiting Stage IIIB and IV Non-small Cell Lung Cancer Analysis of the Surveillance, Epidemiology, and End Results Data William N. William, Jr, MD; Heather Y. Lin, PhD; J. Jack Lee, PhD; Scott M.
More informationMediastinum and pericardium
Mediastinum and pericardium Prof. Abdulameer Al-Nuaimi E-mail: a.al-nuaimi@sheffield.ac.uk E. mail: abdulameerh@yahoo.com The mediastinum: is the central compartment of the thoracic cavity surrounded by
More information10/14/2018 Dr. Shatarat
2018 Objectives To discuss mediastina and its boundaries To discuss and explain the contents of the superior mediastinum To describe the great veins of the superior mediastinum To describe the Arch of
More informationLungStage. Bringing machine learning to Nuclear Medicine and Lung Cancer using Big Data, Machine Learning and Multicenter Studies
LungStage Bringing machine learning to Nuclear Medicine and Lung Cancer using Big Data, Machine Learning and Multicenter Studies Medical Team: Bram Stieltjes, MD PhD; Alex Sauter, MD; Gregor Sommer, MD;
More informationEsophageal Cancer Staging Essentials: The New TNM Staging System (7th edition) and Clinicoradiologic Implications
Esophageal Cancer Staging Essentials: The New TNM Staging System (7th edition) and Clinicoradiologic Implications Poster No.: E-0060 Congress: ESTI 2012 Type: Scientific Exhibit Authors: K. Lee, T. J.
More informationIdentify the lines used in anatomical surface descriptions of the thorax. median line mid-axillary line mid-clavicular line
L 14 A B O R A T O R Y Thorax THORACIC WALL Identify the lines used in anatomical surface descriptions of the thorax. median line mid-axillary line mid-clavicular line Identify the surface landmarks of
More informationLung /1/16. Please submit all questions concerning webinar content through the Q&A panel. Reminder:
1 NAACCR 2015-2016 Webinar Series Collecting Cancer Data: Lung NAACCR 2015 2016 Webinar Series Presented by: Angela Martin amartin@naaccr.org Jim Hofferkamp jhofferkamp@naaccr.org Q&A Please submit all
More informationNeues von der IASLC - Proposals zur 8ten Edition der TNM Klassifikation für das Lungenkarzinom. J. Pfannschmidt
Neues von der IASLC - Proposals zur 8ten Edition der TNM Klassifikation für das Lungenkarzinom J. Pfannschmidt Immunhistochemie durchgängig zur Klassifizierung Integration der molekularen Analyse Neuklassifizierung
More informationMediastinal and Hilar Lymphadenopathy: Cross-Referenced Anatomy on Axial and Coronal Images Displayed by Using Multi-detector row CT 1
Mediastinal and Hilar Lymphadenopathy: Cross-Referenced natomy on xial and Coronal Images Displayed by Using Multi-detector row CT 1 Ju-Hyun Lee, M.D., Kyung Soo Lee, M.D., Tae Sung Kim, M.D., Chin Yi,
More informationLung Cancer Staging: The Revised TNM Classification
Norwegian Society of Thoracic Imaging Oslo, October 2011 Lung Cancer Staging: The Revised TNM Classification Sujal R Desai King s College Hospital, London Lung Cancer The Scale of the Problem Leading cause
More informationTHE DESCENDING THORACIC AORTA
Intercostal Arteries and Veins Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries. The anterior intercostal arteries of the lower spaces
More informationThe 8 th Edition of TNM for Lung Cancer: The IASLC Proposals.
13 th Cambridge Chest Meeting 2015. The 8 th Edition of TNM for Lung Cancer: The IASLC Proposals. Peter Goldstraw, Honorary Consultant Thoracic Surgeon, Royal Brompton Hospital, Emeritus Professor of Thoracic
More information6 th Reprint Manual Pages AJCC 7 th Edition
6 th Reprint Manual Pages AJCC 7 th Edition AJCC 7 th Edition Errata for 6 th Reprint Table 1 Manual No Significant Staging Clarifications for 6 th Reprint AJCC 7 th Edition Errata for 6 th Reprint Table
More informationSyllabus: 6 pages (Page 6 lists corresponding figures for Grant's Atlas 11 th & 12 th Eds.)
PLEURAL CAVITY AND LUNGS Dr. Milton M. Sholley SELF STUDY RESOURCES Essential Clinical Anatomy 3 rd ed. (ECA): pp. 70 81 Syllabus: 6 pages (Page 6 lists corresponding figures for Grant's Atlas 11 th &
More informationThorax Lecture 2 Thoracic cavity.
Thorax Lecture 2 Thoracic cavity. Spring 2016 Dr. Maher Hadidi, University of Jordan 1 Enclosed by the thoracic wall. Extends between (thoracic inlet) & (thoracic outlet). Thoracic inlet At root of the
More informationHistopathology of NSCLC, IHC markers and ptnm classification
ESMO Preceptorship on Non-Small Cell Lung Cancer November 15 th & 16 th 2017 Singapore Histopathology of NSCLC, IHC markers and ptnm classification Prof Keith M Kerr Department of Pathology, Aberdeen University
More information8th Edition of the TNM Classification for Lung Cancer. Proposed by the IASLC
8th Edition of the TNM Classification for Lung Cancer Proposed by the IASLC Introduction Stage classification - provides consistency in nomenclature - improves understanding of anatomic extent of tumour
More informationThe 7th Edition of TNM in Lung Cancer.
10th European Conference Perspectives in Lung Cancer. Brussels, March 2009. The 7th Edition of TNM in Lung Cancer. Peter Goldstraw, Consultant Thoracic Surgeon, Royal Brompton Hospital, Professor of Thoracic
More informationNode-Negative Non-small Cell Lung Cancer
ORIGINAL ARTICLE Node-Negative Non-small Cell Lung Cancer Pathological Staging and Survival in 1765 Consecutive Cases Benjamin M. Robinson, BSc, MBBS, Catherine Kennedy, RMRA, Jocelyn McLean, RN, MN, and
More informationMonitor Images for Respiratory System Dissection
Monitor Images for Respiratory System Dissection **This document includes extra images of the radiology of the bronchopulmonary segments. These imaged are an excellent way to review the three-dimensional
More informationNAACCR Webinar Series 1
Collecting Cancer Data: Lung 2013 2014 NAACCR Webinar Series August 7, 2014 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching
More informationCollecting Cancer Data: Lung
Collecting Cancer Data: Lung NAACCR 2011 2012 Webinar Series 2/2/2012 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching this
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationLung & Pleura. The Topics :
Lung & Pleura The Topics : The Trachea. The Bronchi. The Brochopulmonary Segments. The Lungs. The Hilum. The Pleura. The Surface Anatomy Of The Lung & Pleura. The Root & Hilum. - first of all, the lung
More informationChest and cardiovascular
Module 1 Chest and cardiovascular A. Doss and M. J. Bull 1. Regarding the imaging modalities of the chest: High resolution computed tomography (HRCT) uses a slice thickness of 4 6 mm to identify mass lesions
More informationTumours of the Oesophagus & Gastro-Oesophageal Junction Histopathology Reporting Proforma
Tumours of the Oesophagus & Gastro-Oesophageal Junction Histopathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.01). S1.01 Identification Family name Given
More informationChapter 5: Other mediastinal structures. The Large Arteries. The Aorta. Ascending aorta
Chapter 5: Other mediastinal structures The Large Arteries The Aorta The aorta is the main arterial trunk of the systemic circulation and in the healthy state its wall contain a large amount of yellow
More informationThe 8th Edition of the TNM Classification for Lung Cancer Background, Innovations and Implications for Clinical Practice
The 8th Edition of the TNM Classification for Lung Cancer Background, Innovations and Implications for Clinical Practice University of Torino Lecture 28th June 2017 Torino, Italy Ramón Rami-Porta Thoracic
More informationStaging of lung cancer provides a common language
The 1997 International Staging System for Non-Small Cell Lung Cancer* Have All the Issues Been Addressed? Swan S. Leong, MD; Caio M. Rocha Lima, MD; Carol A. Sherman, MD; and Mark R. Green, MD The International
More informationMEDIASTINAL STAGING surgical pro
MEDIASTINAL STAGING surgical pro Paul E. Van Schil, MD, PhD Department of Thoracic and Vascular Surgery University of Antwerp, Belgium Mediastinal staging Invasive techniques lymph node mapping cervical
More informationAnatomy Lecture 8. In the previous lecture we talked about the lungs, and their surface anatomy:
Anatomy Lecture 8 In the previous lecture we talked about the lungs, and their surface anatomy: 1-Apex:it lies 1 inch above the medial third of clavicle. 2-Anterior border: it starts from apex to the midpoint
More informationOBJECTIVE: To obtain a fundamental knowledge of the root of the neck with respect to structure and function
The root of the neck Jeff Dupree, Ph.D. e mail: jldupree@vcu.edu OBJECTIVE: To obtain a fundamental knowledge of the root of the neck with respect to structure and function READING ASSIGNMENT: Moore and
More informationTheme 30. Structure, topography and function of the lungs and pleura. Mediastinum and its contents. X -ray films digestive and respiratory systems.
Theme 30. Structure, topography and function of the lungs and pleura. Mediastinum and its contents. X -ray films digestive and respiratory systems. STRUCTURE, TOPOGRAPHY AND FUNCTІON OF LUNGS AND PLEURA.
More informationChest X-ray Interpretation
Chest X-ray Interpretation Introduction Routinely obtained Pulmonary specialist consultation Inherent physical exam limitations Chest x-ray limitations Physical exam and chest x-ray provide compliment
More informationThe Itracacies of Staging Patients with Suspected Lung Cancer
The Itracacies of Staging Patients with Suspected Lung Cancer Gerard A. Silvestri, MD,MS, FCCP Professor of Medicine Medical University of South Carolina Charleston, SC silvestri@musc.edu Staging Lung
More informationRole of Surgery in Management of Non Small Cell Lung Cancer. Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City
Role of Surgery in Management of Non Small Cell Lung Cancer Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City Introduction Surgical approach Principle and type of surgery
More information11.1 The Aortic Arch General Anatomy of the Ascending Aorta and the Aortic Arch Surgical Anatomy of the Aorta
456 11 Surgical Anatomy of the Aorta 11.1 The Aortic Arch 11.1.1 General Anatomy of the Ascending Aorta and the Aortic Arch Surgery of the is one of the most challenging areas of cardiac and vascular surgery,
More informationSectional Anatomy Quiz - III
Sectional Anatomy - III Rashid Hashmi * Rural Clinical School, University of New South Wales (UNSW), Wagga Wagga, NSW, Australia A R T I C L E I N F O Article type: Article history: Received: 30 Jun 2018
More informationThe External Anatomy of the Lungs. Prof Oluwadiya KS
The External Anatomy of the Lungs Prof Oluwadiya KS www.oluwadiya.com Introduction The lungs are the vital organs of respiration Their main function is to oxygenate the blood by bringing inspired air into
More informationValidation of the T descriptor in the new 8th TNM classification for non-small cell lung cancer
Original Article Validation of the T descriptor in the new 8th TNM classification for non-small cell lung cancer Hee Suk Jung 1, Jin Gu Lee 2, Chang Young Lee 2, Dae Joon Kim 2, Kyung Young Chung 2 1 Department
More informationNon small cell Lung Cancer
Non small cell Lung Cancer The 13th refresher course for residents in radiation oncology Jiraporn Setakornnukul, M.D. Radiation oncology division, Radiology department Siriraj Hospital, Mahidol University
More informationThe right middle lobe is the smallest lobe in the lung, and
ORIGINAL ARTICLE The Impact of Superior Mediastinal Lymph Node Metastases on Prognosis in Non-small Cell Lung Cancer Located in the Right Middle Lobe Yukinori Sakao, MD, PhD,* Sakae Okumura, MD,* Mun Mingyon,
More informationMEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Hideki Akamatsu, MD a Yuzo
More informationLung Cancer Clinical Guidelines: Surgery
Lung Cancer Clinical Guidelines: Surgery 1 Scope of guidelines All Trusts within Manchester Cancer are expected to follow this guideline. This guideline is relevant to: Adults (18 years and older) with
More informationCervical Mediastinal
Cervical Mediastinal SUSAN ALEXANDER FOR STAGING OF LUNG CANCER mediastinal exploration (CME), or mediastinoscopy, is a surgical procedure to Cervical explore and sample lymph nodes in the space between
More informationProtocol for the Examination of Specimens From Patients With Primary Non-Small Cell Carcinoma, Small Cell Carcinoma, or Carcinoid Tumor of the Lung
Protocol for the Examination of Specimens From Patients With Primary Non-Small Cell Carcinoma, Small Cell Carcinoma, or Carcinoid Tumor of the Lung Version: Protocol Posting Date: June 2017 Includes ptnm
More informationLab #3. Mohammad Hisham Al-Mohtaseb. Jumana Jihad. Ammar Ramadan. 0 P a g e
Lab #3 Mohammad Hisham Al-Mohtaseb Jumana Jihad Ammar Ramadan 0 P a g e Last anatomy lab: Lungs and structure on the mediastinal surfs: 1-the right lung: How do we know it s the right lung??? -the 3 lobes
More informationRight lung. -fissures:
-Right lung is shorter and wider because it is compressed by the right copula of the diaphragm by the live.. 2 fissure, 3 lobes.. hilum : 2 bronchi ( ep-arterial, hyp-arterial ), one artery mediastinal
More informationNumber of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy
CHEST Original Research Number of Lymph Nodes Harvested From a Mediastinal Lymphadenectomy Results of the Randomized, Prospective American College of Surgeons Oncology Group Z0030 Trial LUNG CANCER Gail
More informationTHE THORACIC WALL. Boundaries Posteriorly by the thoracic part of the vertebral column. Anteriorly by the sternum and costal cartilages
THE THORACIC WALL Boundaries Posteriorly by the thoracic part of the vertebral column Anteriorly by the sternum and costal cartilages Laterally by the ribs and intercostal spaces Superiorly by the suprapleural
More informationSurgical management of lung cancer
Surgical management of lung cancer Nick Roubos FRACS Cardiothoracic Surgeon Box Hill Hospital, Epworth Eastern Thoracic Oncology Non Small Cell Lung Cancer (NSCLC) Small Cell Lung Cancer Mesothelioma Pulmonary
More informationThyroid INTRODUCTION ANATOMY SUMMARY OF CHANGES
AJC 7/14/06 1:19 PM Page 67 Thyroid C73.9 Thyroid gland SUMMARY OF CHANGES Tumor staging (T) has been revised and the categories redefined. T4 is now divided into T4a and T4b. Nodal staging (N) has been
More informationEndoscopic UltraSound (EUS) Endoscopic Mucosal Resection (EMR) Moishe Liberman Director C.E.T.O.C.
Endoscopic UltraSound (EUS) Endoscopic Mucosal Resection (EMR) Moishe Liberman Director C.E.T.O.C. Division of Thoracic Surgery Centre Hospitalier de l Université de Montréal Research Grants: Disclosures
More informationCODING STAGE: TNM AND OTHER STAGING SYSTEMS. Liesbet Van Eycken Otto Visser
CODING STAGE: TNM AND OTHER STAGING SYSTEMS Liesbet Van Eycken Otto Visser OVERVIEW PART I Introduction What is stage? Why stage? History and publications of TNM Classification Clinical and pathologic
More informationChapter 2 Staging of Breast Cancer
Chapter 2 Staging of Breast Cancer Zeynep Ozsaran and Senem Demirci Alanyalı 2.1 Introduction Five decades ago, Denoix et al. proposed classification system (tumor node metastasis [TNM]) based on the dissemination
More informationFDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave
FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.
More informationVisceral pleura invasion (VPI) was adopted as a specific
ORIGINAL ARTICLE Visceral Pleura Invasion Impact on Non-small Cell Lung Cancer Patient Survival Its Implications for the Forthcoming TNM Staging Based on a Large-Scale Nation-Wide Database Junji Yoshida,
More informationFDG PET/CT in Lung Cancer Read with the experts. Homer A. Macapinlac, M.D.
FDG PET/CT in Lung Cancer Read with the experts Homer A. Macapinlac, M.D. Patient with suspected lung cancer presents with left sided chest pain T3 What is the T stage of this patient? A) T2a B) T2b C)
More informationThe T4 category of lung cancer is defined by invasion of the
Original Article Results of T4 Surgical Cases in the Japanese Lung Cancer Registry Study Should Mediastinal Fat Tissue Invasion Really be Included in the T4 Category? Shun-ichi Watanabe, MD,* Hisao Asamura,
More informationBoth transoesophageal endoscopic curved-linear ultrasound
STATE OF THE ART: CONCISE REVIEW Endoscopic and Endobronchial Ultrasonography According to the Proposed Lymph Node Map Definition in the Seventh Edition of the Tumor, Node, Metastasis Classification for
More informationTHE GOOFY ANATOMIST QUIZZES
THE GOOFY ANATOMIST QUIZZES 7. LUNGS Q1. Fill in the blanks: the lung has lobes and fissures. A. Right, three, two. B. Right, two, one. C. Left, three, two. D. Left, two, three. Q2. The base of the lung
More informationRadiological Anatomy of Thorax. Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem
Radiological Anatomy of Thorax Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem Indications for Chest x - A chest x-ray may be used to diagnose and plan treatment for various conditions, including: Diseases/Fractures
More informationProtocol for the Examination of Specimens from Patients with Primary Non-Small Cell Carcinoma, Small Cell Carcinoma, or Carcinoid Tumor of the Lung
Protocol for the Examination of Specimens from Patients with Primary Non-Small Cell Carcinoma, Small Cell Carcinoma, or Carcinoid Tumor of the Lung Based on AJCC/UICC TNM, 7th edition Protocol web posting
More informationCT Chest. Verification of an opacity seen on the straight chest X ray
CT Chest Indications: To assess equivocal plain x-ray findings Staging of lung neoplasm Merastatic workup of extra thoraces malignancies Diagnosis of diffuse lung diseases with HRCT Assessment of bronchietasis
More informationSuperior and Posterior Mediastinum. Assoc. Prof. Jenny Hayes
Superior and Posterior Mediastinum Assoc. Prof. Jenny Hayes WARNING This material has been provided to you pursuant to section 49 of the Copyright Act 1968 (the Act) for the purposes of research or study.
More informationEvaluation of the new TNM staging system proposed by the International Association for the Study of Lung Cancer at a single institution
Evaluation of the new TNM staging system proposed by the International Association for the Study of Lung Cancer at a single institution Kotaro Kameyama, MD, a Mamoru Takahashi, MD, a Keiji Ohata, MD, a
More informationAnatomy Sheet #5. In the previous lecture, we finished discussion about the larynx; now we continue with trachea, lungs and pleura.
Anatomy Sheet #5 In the previous lecture, we finished discussion about the larynx; now we continue with trachea, lungs and pleura. Trachea and lungs The knowledge about the pleura and lungs is very important
More informationThe tumor, node, metastasis (TNM) staging system of lung
ORIGINAL ARTICLE Peripheral Direct Adjacent Lobe Invasion Non-small Cell Lung Cancer Has a Similar Survival to That of Parietal Pleural Invasion T3 Disease Hao-Xian Yang, MD, PhD,* Xue Hou, MD, Peng Lin,
More information