Thoracic

Question 1

What are the important staging levels for NSCLC with regards to treatment?

Answer 1

T2 is < 5 cm, T3 is >5 cm or invading beyond visceral pleura
N1 is ipsi hilar nodes, N2 is ipsi mediastinal/subcarinal nodes, N3 is contralateral nodes

Question 2

What makes NSCLC unresectable?

Answer 2

T3 with local invasion or T4, N3.
If N2 disease with T1/2 and non locally invasive T3, should get neoadj chemorad to assess response.

Question 3

What’s treatment for small cell lung cancer?

Answer 3

Can resect for T1-2 N0 disease only. Otherwise chemorad

Question 4

What’s chemo regiment for NSCLC and SCLC?

Answer 4

NSCLC: Carboplatin/taxol
SCLC: Cisplatin, etoposide

Question 5

What paraneoplastic syndromes are associated with lung cancer?

Answer 5

NSCLC: PTHrP
Small cell: ACTH

Question 6

What post-op FEV1/DLCO do you need to be candidate for lung resection? What do you check if they don’t meet criteria?

Answer 6

> 60%
Cardiopulmonary exercise testing: ideally VO2 max >20mL/kg/min. If < 10 then high risk.

Question 7

What stations are aortopulmonary window?

Answer 7

Station 5/6