TNM Staging for Non-small Cell Lung Cancer

Knowing lung cancer stage is an important part of the assessment of patients with non-small cell lung cancer. These patients undergo staging as part of the process of considering prognosis and treatment.

• T Staging (Primary Tumor)
  This staging show how big the tumor is.
  
  
• N Staging (Lymph Nodes)
  Whether the cancer cell is metastasis to lymph nodes or no. Patients with mediastinal nodes larger than 1cm in transverse diameter on CT who otherwise have resectable lung disease should undergo further staging evaluation. However, PET has been found to be more accurate than CT in mediastinal nodal staging for non-small cell lung cancer. A negative PET is highly specific, but positive PET nodes are not always malignant and histological confirmation may be required before advancing to definitive management.
  
  
• M Staging (Distant Metastasis)
  This staging shows that the cancer is metastasis to other organ.

Guidelines for M Staging:

• If clinical assessment for metastases is abnormal, then further investigations are indicated, as metastases will be confirmed in 50% of such cases.
• Routine bone scanning in non-small cell lung cancer is of little clinical value if there are no abnormal clinical or biochemical features.
• The role of routine brain imaging in non-small cell lung cancer asymptomatic patients is unclear, but the detection rate is low.

Main article - Non-small Cell Lung Cancer Prognosis