Lung Staging and Grading

Question 1

Which patients will have surgery?

Answer 1

• IA (SABR maybe)
• IB
• IIA
• Maybe lower groups, if they are considered resectable

Question 2

How are T1 tumours defined?

Answer 2

• <3cm
• a <1
• b 1-2cm
• c 2-3cm
• No further invasion than lobar bronchi

Question 3

How are T2 tumours defined?

Answer 3

• 3-5cm
• a 3-4cm
• b 4-5cm
• Disease can now be in lobar bronchi but not carina
• could be atelectasis or obstructive pneumonitis all the ay to the hylem.

Question 4

How are T3 tumours defined?

Answer 4

• 5-7cm
• two separate nodules in the same lobe (diff lobes = T4)
• ## Phrenic nerve involvement

Question 5

How are T4 tumours defined?

Answer 5

• > 7cm
• Invades surrounding structures: diaphragm, great vessels, trachea, oesophagus, vertebral body, carina
• Or separate nodules in different lobes

Question 6

How is nodal involvement defined?

Answer 6

• N0 = none
• N1 = lymph mets in ipsilateral intrapulmonary/peribronchal hilar lymph nodes (including by direct extension)
• N2 = within or outside the lung
• N3 = mets in contralateral nodes or supraclavicular lymph nodes