Onco - Lung Tx Stage 0, I and II NSCLC Flashcards
Treatment for Stage 0
Surgical resection after bronchoscopic localization (fiberoptic bronchoscope)
% of Surgically resected Stage 0 that becomes second primary lung CA
5%
X-ray density completely surrounded by normal aerated lung with circumscribed margins of any shape, usually 1-6cm in greatest diameter
solitary pulmonary nodule
PET scan may be useful for lesions with diameter of
7-8mm
Clinical characteristics that are Independent predictors of malignancy
age
cigarette smoking status
prior cancer diagnosis
Radiologic characteristics that are independent predictors of malignancy
nodule diameter
spiculation
upper lobe location
two radiographic criteria thought to predict the benign nature of a solitary pulmonary nodule:
lack of growth over a period >2 years
certain characteristic patterns of calcification
T/F calcification alone exclude malignancy
F; it does not
dense central nidus, multiple punctate foci on imaging
a. benign
b. malignant
A
bulls eye
a. malignant
b. granuloma
c. hamartoma
B
popcorn ball
a. malignant
b. granuloma
c. hamartoma
C
relatively larg lesion, lack of or asymmetric calcification, chest symptoms, atelectasis, pneumonitis, or growth of lesion revealed by comparison with an old xray or CT or positive PET scan
a. malignant
b. benign
A
Ground glass opacities have often been observed and when biopsied, are found to be (3)
atypical adenomatous hyperplasia
adenocarcinoma in situ
minimally invasive adenocarcinoma
characteristic of a usual AAH nodule
<5mm
minimally hazy
nonsolid or ground glass
Minimaly invasive adenocarcinoma typical lesion
solid, <5mm central solid component
Characteristic of lepidic adenocarcinomas
usually solid but may be nonsolid
Treatment of choice for clinical stage I and II NSCLC
Surgical resection given they are able to tolerate the procedure
Stage IA NSCLC,
a. lobectomy
b. wedge resection
A;
Pneumonectomy is reserved for patients with
excellent pulmonary reserve
5 year survival rates for stage I NSCLC
60-80%
5 year survival rates for stage II NSCLC
40-50%
On the right side, these mediastinal stations should be dissected
2R 4R 7 8R 9R
On the left side, these mediastinal stations should be dissected
5,6,7,8L,9L
Lung CA stages that demonstrated superior 4 years survival in patients undergoing resection and a complete mediastinal node dissection compared with lymph node sampling
Stages I-IIIA
