Small Cell Lung Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]-Stage Inf
Small Cell Lung Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]-Stage Information for Small Cell Lung Cancer
Staging Systems
Several staging systems have been proposed for small cell lung cancer (SCLC). These staging systems include the following:
Tips to Help You Manage Side Effects
As you get ready to start treatment, it’s normal to feel nervous about side effects you might face. To help you prepare, here’s a treatment-by-treatment guide to the most common ones.Keep in mind that side effects vary even between two people on the same treatment. That's because every person -- and every cancer case -- is unique. The good news is most side effects are temporary and there are ways you can manage them.
Read the Tips to Help You Manage Side Effects article > >
Limited-Stage Disease
No universally accepted definition of this term is available. Limited-stage disease (LD) SCLC is confined to the hemithorax of origin, the mediastinum, or the supraclavicular nodes, which can be encompassed within a tolerable radiation therapy port.
Patients with pleural effusion, massive pulmonary tumor, and contralateral supraclavicular nodes have been both included within and excluded from LD by various groups.
Extensive-Stage Disease
Extensive-stage disease (ED) SCLC has spread beyond the supraclavicular areas and is too widespread to be included within the definition of LD. Patients with distant metastases (M1) are always considered to have ED.[3,4]
IASLC-AJCC TNM Staging System
The AJCC TNM defines LD as any T, except for T3-4, due to multiple lung nodals that do not fit in a tolerable radiation field, any N, and M0.[1] This corresponds to TNM stages I to IIIB. Extensive disease is TNM stage IV with distant metastases (M1) including malignant pleural effusions.[3,4]
The IASLC conducted an analysis of clinical TNM staging for SCLC using the sixth edition of the AJCC TNM staging system for lung cancer. Survivals for patients with clinical stages I and II disease are significantly different from those for patients with stage III disease with N2 or N3 involvement.[3] Patients with pleural effusion have an intermediate prognosis between LD and ED with hematogenous metastases and will be classified as having M1 disease (or ED). Application of the TNM system will not change how patients are managed; however, the analysis suggests that, in the context of clinical trials in LD, accurate TNM staging and stratification may be important.[3]
Staging Evaluation
Staging procedures for SCLC are important in distinguishing patients with disease limited to their thorax from those with distant metastases. At the time of initial diagnosis, approximately two-thirds of patients with SCLC have clinical evidence of metastases; most of the remaining patients have clinical evidence of extensive nodal involvement in the hilar, mediastinal, and sometimes supraclavicular regions.
Several staging systems have been proposed for small cell lung cancer (SCLC). These staging systems include the following:
Recommended Related to Lung Cancer
Tips to Help You Manage Side Effects
As you get ready to start treatment, it’s normal to feel nervous about side effects you might face. To help you prepare, here’s a treatment-by-treatment guide to the most common ones.Keep in mind that side effects vary even between two people on the same treatment. That's because every person -- and every cancer case -- is unique. The good news is most side effects are temporary and there are ways you can manage them.
Read the Tips to Help You Manage Side Effects article > >
- American Joint Committee on Cancer (AJCC) Tumor, Node, and Metastasis (TNM).[1]
- Veterans Administration Lung Study Group (VALG).[2]
- International Association for the Study of Lung Cancer (IASLC).[3]
Limited-Stage Disease
No universally accepted definition of this term is available. Limited-stage disease (LD) SCLC is confined to the hemithorax of origin, the mediastinum, or the supraclavicular nodes, which can be encompassed within a tolerable radiation therapy port.
Patients with pleural effusion, massive pulmonary tumor, and contralateral supraclavicular nodes have been both included within and excluded from LD by various groups.
Extensive-Stage Disease
Extensive-stage disease (ED) SCLC has spread beyond the supraclavicular areas and is too widespread to be included within the definition of LD. Patients with distant metastases (M1) are always considered to have ED.[3,4]
IASLC-AJCC TNM Staging System
The AJCC TNM defines LD as any T, except for T3-4, due to multiple lung nodals that do not fit in a tolerable radiation field, any N, and M0.[1] This corresponds to TNM stages I to IIIB. Extensive disease is TNM stage IV with distant metastases (M1) including malignant pleural effusions.[3,4]
The IASLC conducted an analysis of clinical TNM staging for SCLC using the sixth edition of the AJCC TNM staging system for lung cancer. Survivals for patients with clinical stages I and II disease are significantly different from those for patients with stage III disease with N2 or N3 involvement.[3] Patients with pleural effusion have an intermediate prognosis between LD and ED with hematogenous metastases and will be classified as having M1 disease (or ED). Application of the TNM system will not change how patients are managed; however, the analysis suggests that, in the context of clinical trials in LD, accurate TNM staging and stratification may be important.[3]
Staging Evaluation
Staging procedures for SCLC are important in distinguishing patients with disease limited to their thorax from those with distant metastases. At the time of initial diagnosis, approximately two-thirds of patients with SCLC have clinical evidence of metastases; most of the remaining patients have clinical evidence of extensive nodal involvement in the hilar, mediastinal, and sometimes supraclavicular regions.