 |
« CTSNet
Online Books |
 |
LUNG
CANCER
A Handbook for Staging, Imaging, and Lymph Node Classification
by Clifton F. Mountain, MD; Herman I.
Libshitz, MD; and Kay E. Hermes |
|
 |
|
|
|
|
|
|
Preface |
page
3 |
For
the past decade, the scientific community has
been well served by wide application of The
International System for Staging Lung Cancer1.
The system was adopted in 1986 and published
in manuals for staging of the American Joint
Committee on Cancer (AJCC) and the Union Internationle
Contre le Cancer (UICC)2-3. These recommendations
for classifying lung cancer according to TNM
principles (T-primary tumor, N-regional lymph
nodes, M-distant metastasis) and stage grouping
of the TNM subsets were based on studies of
the survival experience of patients treated
for primary lung cancer in a contemporary time
frame. With extensive use of the system over
time, a need for greater specificity in identifying
patient groups became apparent, and two classification
problems emerged: (1) heterogeneity existed
with respect to the end results for the TNM
subsets in stage I and stage IIIA disease,
and (2) inconsistency resulted from the use
of multiple systems for classifying regional
lymph nodes. These problems were addressed
and resolved with the least possible disruption
in the International Staging System by revising
the rules for stage grouping of the TNM subsets
and recommending a new schema for classifying
regional lymph nodes4-5. The revised rules
for stage grouping and the new lymph node mapping
schema were adopted by the AJCC and the UICC6-7.
The
purpose of this handbook is to provide a convenient
reference for using the revised recommendations
for staging and regional lymph node classification.
Definitions for the TNM descriptors remain
the same, as defined in the International System1,
except for two minor additions to aid in classifying
multiple lung nodules: T4 is used to designate
satellite tumor nodules in the ipsilateral
primary tumor lobe of the lung; all other separate
nodules in the non-primary tumor lobes are
designated M1. The revised stage grouping is
as follows: T1 N0 M0 tumors are assigned to
stage IA and T2 N0 M0 tumors to stage IB; the
T1 N1 M0 subset is designated stage IIA and
the two subsets, T2 N1 M0 and T3 N0 M0, are
assigned to stage IIB; T3 N1 M0 tumors and
those classified T1-2-3 N2 M0 are included
in stage IIIA; stages IIIB, and IV remain the
same. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Copyright © 1999
- 2003 by CF Mountain and HI Libshitz, Houston, Texas. All rights
reserved.
Printed in the United States of America by Charles P. Young Company.
No part of this manual may be reproduced by any means without the
prior written consent of the authors. |
|