Staging Of Tumours

Question 1

What categories are cancers staged on?

Answer 1

T= tumour size
N = nodal involvement 
M = metastisis

Question 2

How is tumour size determined?

Answer 2

CT
PET-CT
bronchoscopy

Question 3

How does tumour size range from TX-T4?

Answer 3

TX= cannot assess 1st tumour
T0= no evidence of 1st tumour
Tis= carcinoma in situ
T1 ≤ 3cm no main bronchus inv.
T2 3-5 cm main bronchus (not carina), collapse/obstructive pneumonitis
T3 5-7 cm or invade chest wall, phrenic n., parietal pericardium
T4 > 7 cm or invade diaphragm, mediastinum, heart, great vessels, recurrent laryngeal, oesophagus, vertebral body, carina

Question 4

How is nodal involvement measured?

Answer 4

PET-CT, mediastinoscopy, CT, EBUS

Question 5

How is nodal involvement range from N0-N3?

Answer 5

N0= no reginal LN metastasis 
N1= ipsilateral peribronchial, hilar, intrapulmonary LN 
N2= ipsilateral mediastinal, subcarinal 
N3 = contralateral mediastinal & hilar, scalene, supraclavicular

Question 6

How is metastasis measured?

Answer 6

PET-CT, CT, bone scan

Question 7

How is metastasis measured from M0-Mac

Answer 7

M0= no distant metastasis
M1= distant metastasis
M1a=
- Separate tumour nodule in contralateral lobe
- Pleural/pericardial nodule or malignant pleural/pericardial effusion
M1b= single distant metastasis
M1c= multiple distant metastasis