Just like non-small cell lung cancer, staging in SCLC play an important role because it guides treatment and helps to predict outcomes. However, the TNM staging system is useless in SCLC because at presentation more than 90% of SCLC have either locally invasive Mediastinal disease or metastases. However, in the few patients who do present with much localized SCLC and undergo surgical resection, the TNM staging system is important.
The staging system that used in small cell lung cancer divides them into:
- Small Cell Lung Cancer Limited stage
Limited disease essentially consists of tumour involving a single hemithorax and its regional lymph nodes. - Small Cell Lung Cancer Extensive stage
Limited stage defines a group who have a better prognosis and who benefit from the routine addition of thoracic radiotherapy.
SMALL CELL LUNG CANCER STAGING PROCEDURES
Until recently full anatomical staging using several imaging modalities and bone marrow biopsy has been standard practice in Australia and the USA. In contrast, European groups have used clinical and blood markers along with limited imaging techniques to group patients into limited disease or extensive disease stages and to predict prognosis. There is now good evidence that the latter approach is at least as good at determining treatment groups and predicting outcome and it is substantially cheaper, less invasive and simpler.
This more limited and targeted approach has now been advocated for routine use by a number of North American expert panels. It essentially consists of information from the clinical examination, a number of blood markers and a step-wise imaging approach to establish extensive disease or limited disease stage. Once a site of extensive disease is established further imaging is not required.
Main article - Small Cell Lung Cancer Prognosis
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