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Lung Cancer
Histologic Classification
of Non-small Cell Lung
Cancer

Squamous cell (epidermoid)
carcinoma
a.

Adenocarcinoma
a.
b.
c.
d.

spindle cell variant
acinar
papillary
bronchoalveolar
solid tumor with mucin
Large cell carcinoma
a.
giant cell
b.
clear cell

Adenosquamous carcinoma

Undifferentiated carcinoma
TNM Staging
Stage
TNM
5-year
Survival
O
Carcinoma in situ
1A
TIN0M0
67%
1B
T2N0M0
57%
IIA
T1N1M0
55%
IIB
T2N1M0
T3N0M0
38%
IIIA
T3N1M0
T1N2M0
T2-3N2M0
23%
IIIB
T4N0-2
T1-4N3M0
5%
IV
T1-4N0-3M1
1%

Survival is very heavily dependent upon TNM tumor stage

Stages 1A through IIIB are dependent on the T and N
classification

Stage IV disease is defined by metastatic disease

Major distinctions:
a.
Stage IIA and stage IIB
b.
Stage IIIA and stage IIIB
--Regional nodal stations for lung cancer staging
Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782
Copyright © 2006 by the American Roentgen Ray Society
--Regional nodal stations for lung cancer staging
Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782
Copyright © 2006 by the American Roentgen Ray Society
--Regional nodal stations for lung cancer staging
Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782
Copyright © 2006 by the American Roentgen Ray Society
--Regional nodal stations for lung cancer staging
Ko, J. P. et al. Am. J. Roentgenol. 2000;174:775-782
Copyright © 2006 by the American Roentgen Ray Society
STAGE 0
●
TisN0M0
●
TREATMENT
–
ENDOSCOPY
–
SURGERY
–
RADIATION
STAGE 1A
●
T1N0M0
●
TREAMENT
–
SURGERY
–
RADIATION
STAGE 1B
●
T2N0M0
●
TREATMENT
–
SURGERY
–
RADIATION
STAGE IIA
●
T1N1M0
●
TREATMENT
–
SURGERY
–
RADIATION
–
CHEMOTHERAPY
STAGE IIB
●
T2N1M0
●
T3N0M0
●
TREATMENT
–
SURGERY
–
RADIATION
–
CHEMOTHERAPY
STAGE IIIA
●
T3N1M0
●
T1N2M0
●
T2-3N2M0
●
TREATMENT
–
RADIATION
–
CHEMOTHERAPY
STAGE IIIB
●
T4N0-2M0
●
T1-4N3M0
●
TREATMENT
–
RADIATION
–
CHEMOTHERAPY
STAGE IV
●
T1-4 N0-3M1
●
TREAMENT
–
RADIATION
–
CHEMOTHERAPY
–
SURGERY
SPECIAL SITUATIONS
●
Pancoast’s Tumor
–
–
–
●
Medically Unfit
–
–
–
●
Radiation
Chemotherapy
Surgery
Radiation
Chemotherapy
Ablation
Bronchial Obstruction
–
–
–
Stent
Laser
Puotodynamic Therapy
SUMMARY
●
Difficult disease to treat
●
usually presents at late stage
●
Best results when found early
●
Screening though effective