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S2 Respiratory System > lung cancer lecture 3 deck 3 > Flashcards

lung cancer lecture 3 deck 3 Flashcards

1
Q

how do you determine staging of lung cancer?

A
  • clinical history/ examination
  • performance status
  • pulmonary function
  • TNM international system for staging lung cancer
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2
Q

what does the T in the TNM international system account for?

A

size and position of the tumour

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3
Q

what does the N in the TNM international system account for?

A

whether cancer cells have spread into the lymph node

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4
Q

what does the M in the TNM international system account for?

A

whether the tumour has spread anywhere else in the body i.e. metastases

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5
Q

what imaging is used to determine T stage? what for?

A

CT, PET-CT, bronchoscopy, assessing size position and chest wall/ mediastinal invasion

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6
Q

what imaging is used to determine N stage?

A

CT, PET-CT, EBUS/EUS, mediastinoscopy

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7
Q

what imaging is used to determine M stage?

A

CT, PET-CT, bone scan

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8
Q

what does TX account for?

A

primary tumour cannot be assessed

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9
Q

what does T0 account for?

A

no evidence of primary tumour

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10
Q

what does Tis stand for?

A

carcinoma in situ (neoplasia)

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11
Q

what does T1 account for? what are T1’s subdivisions?

A

tumour < 3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of involvement of the main bronchus. Subdivisions include a (minimally invasive adenocarcinoma tumour <=1 cm in greatest dimension), b (<= 2 cm), c (<= 3 cm)

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12
Q

what does T2 account for? what are T2’s subdivisions?

A

(a) tumour 3-4 cm, (b) 4-5 cm or any of the following: involves main bronchus but not carina, invades visceral pleura, associated with atelectasis or obstructive pneumonitis that extends to the hilar region involving part or all the lung

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13
Q

what does T3 account for? what are T3’s subdivisions?

A

5-7 cm, or one that directly invades any of the following:
- chest wall (including sulcus tumours)
- phrenic nerve
- parietal pericardium
or separate tumour nodules int the same lobe as the primary

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14
Q

what does T4 stand for? what are T4’s subdivisions?

A 
>7cm, or invades any of the following: 
- diaphragm 
- mediastinum 
- heart
- great vessels 
- trachea
- recurrent laryngeal nerve
- oesophagus 
- vertebral body 
- carina 
separate tumour nodules in a different ipsilateral lobe
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15
Q

what does N0 account for?

A

no regional lymph node metastases

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16
Q

what does N1 account for?

A

ipsilateral peribronchial, hilar or intrapulmonary nodes including by direct extension

17
Q

what does N2 account for?

A

ipsilateral mediastinal, subcarinal

18
Q

what does N3 account for?

A

contralateral mediastinal, contralateral hilar, scalene or supraclavicular

19
Q

how many lymph nodes are <1 cm? what metastases % do they represent?

A

336, 13%

20
Q

how many lymph nodes are 1-1,9 cm? what metastases % do they represent?

A

57, 25%

21
Q

how many lymph nodes are 2-2,9 cm? what metastases % do they represent?

A

13, 62%

22
Q

how many lymph nodes are 3-3,9 cm? what metastases % do they represent?

A

6, 67%

23
Q

how many lymph nodes are >4 cm? what metastases % do they represent?

A

2, 100%

24
Q

what does M0 account for?

A

no distant metastasis

25
Q

what does M1 account for? what are M1’s subdivisions?

A

distant metastasis, a (separate tumour nodule in a contralateral lobe or tumour with pleural or pericardial nodules or malignant pleural/ pericardial effusion), b (single distant metastasis), c (multiple distant metastasis)

26
Q

what are the commonest metastases after a primary lung cancer?

A

brain, skeleton, adrenal, liver

27
Q

what % 5YS for stage 4 on TNM scale?

A

1% 5YS

28
Q

what does a T4 mean for the TNM stage? what is the % 5YS?

A

stage 3B, 5% 5YS

S2 Respiratory System (43 decks)

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