Lung cancer staging: a concise update
- Ramón Rami-Porta1,2,
- Sergi Call1,3,
- Christophe Dooms4,
- Carme Obiols1,
- Marcelo Sánchez5,
- William D. Travis6 and
- Ivan Vollmer5
- 1Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain
- 2Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Terrassa, Barcelona, Spain
- 3Department of Morphological Sciences, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
- 4Department of Respiratory Diseases, University Hospitals, KU Leuven, Leuven, Belgium
- 5Centre of Imaging Diagnosis, Radiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
- 6Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
- Ramón Rami-Porta, MD, Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, Plaza Dr Robert 5, 08221 Terrassa, Barcelona, Spain. email: rramip{at}yahoo.es
Abstract
Diagnosis and clinical staging of lung cancer are fundamental to plan therapy. The techniques for clinical staging – anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures – should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential to achieve a complete resection. In resected tumours, pathologic staging, with the systematic study of the resected specimens, is the strongest prognosticator and is essential to make further decisions on therapy. In the present decade, the guidelines on lung cancer staging of the American College of Chest Physicians and the European Society of Thoracic Surgeons are based on the best available evidence and are widely followed. Recent advances in the classification of the adenocarcinoma of the lung, with the definition of adenocarcinoma in situ, minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma, and the publication of the 8th edition of the tumour, node and metastasis classification of lung cancer, have to be integrated into the staging process. The present review complements the latest guidelines on lung cancer staging by providing an update of all these issues.
Abstract
Lung cancer staging is a multidisciplinary activity that involves specialists in imaging, endoscopists, surgeons and pathologists at clinical and pathologic staging
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Rami-Porta has nothing to disclose.
Conflict of interest: Dr. Call has nothing to disclose.
Conflict of interest: Dr. Dooms has nothing to disclose.
Conflict of interest: Dr. Obiols has nothing to disclose.
Conflict of interest: Dr. sánchez has nothing to disclose.
Conflict of interest: Dr. Travis has nothing to disclose.
Conflict of interest: Dr. Vollmer has nothing to disclose.
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- Copyright ©ERS 2018