Pancoast tumor classification: Difference between revisions

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Latest revision as of 17:55, 15 March 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The staging of the pancoast tumor is based on the TNM system. Pancoast tumors staging starts at T3 always, as there is an invasion of the chest wall. Invasion of the vertebral body or the subclavian vessels is regarded as T4.

Classification

The staging of pancoast tumor is based on the TNM system.^[1]^[2]^[3]
Pancoast tumors staging starts at T3 always, as there is invasion of chest wall. Invasion of vertebral body or the subclavian vessels is regarded as T4.

Stage	T	N	M
IIB	T3	N0	M0
IIIA	T3	N1-2	M0
IIIB	T4	Any N	M0
IIIB	Any T	N3	M0
IV	Any T	Any N	M1

TNM-8th Edition
T	T1	Tumor size ≤3cm in greatest dimension
	T2	Tumor size >3cm to ≤5cm Tumor of any size that invades the visceral pleura involves main bronchus, irrespective of distance to the carina shows an atelectasis or obstructive pneumonitis that extends to the hilum
	T3	Tumor size >5cm to 7cm Pancoast tumor that involves thoracic nerve roots T1 and T2 only. Tumor of any size that invades the chest wall invades the pericardium invades the phrenic nerve involves main bronchus, irrespective of distance to the carina shows one or more satellite nodules in the same lung lobe
	T4	Tumor size >7cm Involvement of C8 or higher nerve roots, brachial plexus, subclavian vessels or spine Tumor of any size that invades mediastinal fat or mediastinal structures invades the diaphragm involves the carina shows one or more satellite nodules in another lobe on the ipsilateral side
N	N0	No regional lymph node metastasis
	N1	Nodes are ipsilateral nodes within the lung up to hilar nodes.
	N2	Nodes represent ipsilateral mediastinal or subcarinal lymphadenopathy.
	N3	Nodes represent contralateral mediastinal or contralateral hilar lymphadenopathy or any scalene or supraclavicular nodes.
M	M0	No distant metastasis
M	M1	Distant metastasis

References

↑ Naruke T (1993). "Significance of lymph node metastases in lung cancer". Semin. Thorac. Cardiovasc. Surg. 5 (3): 210–8. PMID 8353149.
↑ Kraut MJ, Vallières E, Thomas CR (2003). "Pancoast (superior sulcus) neoplasms". Curr Probl Cancer. 27 (2): 81–104. PMID 12717414.
↑ Mountain CF (1986). "A new international staging system for lung cancer". Chest. 89 (4 Suppl): 225S–233S. PMID 3514171.

Template:WH Template:WS

[pmid8353149-1] Naruke T (1993). "Significance of lymph node metastases in lung cancer". Semin. Thorac. Cardiovasc. Surg. 5 (3): 210–8. PMID 8353149.

[pmid12717414-2] Kraut MJ, Vallières E, Thomas CR (2003). "Pancoast (superior sulcus) neoplasms". Curr Probl Cancer. 27 (2): 81–104. PMID 12717414.

[pmid3514171-3] Mountain CF (1986). "A new international staging system for lung cancer". Chest. 89 (4 Suppl): 225S–233S. PMID 3514171.

[1]

[2]

[3]

@@ Line 4: / Line 4: @@
 {{CMG}}; {{AE}}
 ==Overview==
+The [[Staging (pathology)|staging]] of the pancoast tumor is based on the [[TNM system]]. Pancoast tumors [[Cancer staging|staging]] starts at T3  always, as there is an [[Chest wall|invasion of the chest wall]]. [[Invasion]] of the [[vertebral body]] or the [[Subclavian|subclavian vessels]] is regarded as T4.
 ==Classification==
-*The staging of pancoast tumor is based on the TNM system.
+*The [[Staging of lung cancer|staging]] of pancoast tumor is based on the [[TNM system]].<ref name="pmid8353149">{{cite journal |vauthors=Naruke T |title=Significance of lymph node metastases in lung cancer |journal=Semin. Thorac. Cardiovasc. Surg. |volume=5 |issue=3 |pages=210–8 |year=1993 |pmid=8353149 |doi= |url=}}</ref><ref name="pmid12717414">{{cite journal |vauthors=Kraut MJ, Vallières E, Thomas CR |title=Pancoast (superior sulcus) neoplasms |journal=Curr Probl Cancer |volume=27 |issue=2 |pages=81–104 |year=2003 |pmid=12717414 |doi= |url=}}</ref><ref name="pmid3514171">{{cite journal |vauthors=Mountain CF |title=A new international staging system for lung cancer |journal=Chest |volume=89 |issue=4 Suppl |pages=225S–233S |year=1986 |pmid=3514171 |doi= |url=}}</ref>
-*Pancoast tumors staging starts at T3  always, as there is invasion of chest wall. Invasion of vertebral body or the subclavian vessels is regarded as T4.
+*Pancoast tumors staging starts at T3  always, as there is [[Chest wall|invasion of chest wall]]. [[Invasion]] of [[vertebral body]] or the [[Subclavian|subclavian vessels]] is regarded as T4.
 {| class="wikitable" align="right"
 | style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Stage'''
@@ Line 13: / Line 15: @@
 | style="background:#4479BA; color: #FFFFFF;" align="center" + |'''M'''
 |-
-| style="background:#DCDCDC;" align="center" + |IA
+| style="background:#DCDCDC;" align="center" + |IIB
-| style="background:#F5F5F5;" + |T1
+| style="background:#F5F5F5;" + |T3
-| style="background:#F5F5F5;" + |N0
-| style="background:#F5F5F5;" + |M0
-|-
-| style="background:#DCDCDC;" align="center" + |IB
-| style="background:#F5F5F5;" + |T2
 | style="background:#F5F5F5;" + |N0
 | style="background:#F5F5F5;" + |M0
 |-
-| style="background:#DCDCDC;" align="center" + |IIA
+| style="background:#DCDCDC;" align="center" + |IIIA
 | style="background:#F5F5F5;" + |T3
-| style="background:#F5F5F5;" + |N0
+| style="background:#F5F5F5;" + |N1-2
 | style="background:#F5F5F5;" + |M0
 |-
-| style="background:#DCDCDC;" align="center" + |IIB
+| style="background:#DCDCDC;" align="center" + |IIIB
-| style="background:#F5F5F5;" + |T1-3
+| style="background:#F5F5F5;" + |T4
-| style="background:#F5F5F5;" + |N1
+| style="background:#F5F5F5;" + |Any N
 | style="background:#F5F5F5;" + |M0
 |-
-| style="background:#DCDCDC;" align="center" + |III
+| style="background:#DCDCDC;" align="center" + |IIIB
-| style="background:#F5F5F5;" + |T4
+| style="background:#F5F5F5;" + |Any T
-| style="background:#F5F5F5;" + |Any N
+| style="background:#F5F5F5;" + |N3
 | style="background:#F5F5F5;" + |M0
 |-
@@ Line 44: / Line 41: @@
 |}
 {| class="wikitable" align="center"
-| colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''AJCC 2010'''
+| colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |TNM-8th Edition
 |-
 ! rowspan="4" style="background:#DCDCDC;" align="center" + | T
 | style="background:#DCDCDC;" align="center" + | T1
-| style="background:#F5F5F5;" + |<2 cm in greatest dimension
+| style="background:#F5F5F5;" + |[[Tumor|Tumor size]] ≤3cm in greatest [[dimension]]
 |-
 | style="background:#DCDCDC;" align="center" + |T2
-| style="background:#F5F5F5;" + |>2 cm in greatest dimension
+| style="background:#F5F5F5;" + |
+* [[Tumor|Tumor size]] >3cm to ≤5cm
+* [[Tumor]] of any size that
+** invades the [[visceral pleura]]
+** involves [[main bronchus]], irrespective of distance to the [[carina]]
+** shows an [[atelectasis]] or [[Pneumonitis|obstructive pneumonitis]] that extends to the [[hilum]]
 |-
 | style="background:#DCDCDC;" align="center" + |T3
-| style="background:#F5F5F5;" + |Beyond the [[pancreas]] but without involvement of the [[superior mesenteric artery]]
+| style="background:#F5F5F5;" + |
+* [[Tumor]] size >5cm to 7cm
+* Pancoast tumor that involves [[Thoracic nerve|thoracic nerve roots]] T1 and T2 only.
+* [[Tumor]] of any size that
+** invades the [[chest wall]]
+** invades the [[pericardium]]
+** invades the [[Phrenic nerves|phrenic nerve]]
+** involves [[main bronchus]], irrespective of distance to the [[carina]]
+** shows one or more satellite [[nodules]] in the same [[Lung|lung lobe]]
 |-
 | style="background:#DCDCDC;" align="center" + |T4
-| style="background:#F5F5F5;" + |Involvement of the ''[[celiac axis]]'' or [[superior mesenteric artery]] (unresectable [[tumor]])
+| style="background:#F5F5F5;" + |
+* [[Tumor]] size >7cm
+* Involvement of [[C8]] or [[Nerve root|higher nerve roots]], [[brachial plexus]], [[Subclavian|subclavian vessels]] or [[spine]]
+* [[Tumor]] of any size that
+** invades [[mediastinal]] [[fat]] or [[Mediastinal|mediastinal structures]]
+** invades the [[diaphragm]]
+** involves the [[carina]]
+** shows one or more satellite [[nodules]] in another [[lobe]] on the [[Ipsilateral|ipsilateral side]]
 |-
-! rowspan="2" style="background:#DCDCDC;" align="center" + | N
+! rowspan="4" style="background:#DCDCDC;" align="center" + | N
 | style="background:#DCDCDC;" align="center" + |N0
 | style="background:#F5F5F5;" + |No regional [[lymph node]] [[metastasis]]
 |-
 | style="background:#DCDCDC;" align="center" + |N1
-| style="background:#F5F5F5;" + |Regional [[lymph node]] [[metastasis]]
+| style="background:#F5F5F5;" + |[[Lymph node|Nodes]] are [[ipsilateral]] [[Lymph node|nodes]] within the [[lung]] up to [[Hilar|hilar nodes]].
+|-
+| style="background:#DCDCDC;" align="center" + |N2
+| style="background:#F5F5F5;" + |[[Lymph node|Nodes]] represent [[ipsilateral]] [[mediastinal]] or subcarinal [[lymphadenopathy]].
+|-
+| style="background:#DCDCDC;" align="center" + |N3
+| style="background:#F5F5F5;" + |[[Lymph node|Nodes]] represent [[contralateral]] [[mediastinal]] or [[contralateral]] [[hilar]] [[lymphadenopathy]] or any [[scalene]] or [[supraclavicular]] [[Lymph node|nodes]].
 |-
-! rowspan="2" style="background:#DCDCDC;" align="center" + | M
+| rowspan="2" style="background:#DCDCDC;" align="center" + | M
 | style="background:#DCDCDC;" align="center" + |M0
 | style="background:#F5F5F5;" + |No distant [[metastasis]]
@@ Line 74: / Line 97: @@
 |-
 |}
-There is no established system for the classification of [disease name].
-OR
-[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
-OR
-[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
-[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
-OR
-Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
-OR
-If the staging system involves specific and characteristic findings and features:
-According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
-OR
-The staging of [malignancy name] is based on the [staging system].
-OR
-There is no established system for the staging of [malignancy name].
-==Classification==
-*There is no established system for the classification of [disease name].
-OR
-*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
-**[Group1]
-**[Group2]
-**[Group3]
-**[Group4]
-OR
-*[Disease name] may be classified into [large number > 6] subtypes based on:
-**[Classification method 1]
-**[Classification method 2]
-**[Classification method 3]
-*[Disease name] may be classified into several subtypes based on:
-**[Classification method 1]
-**[Classification method 2]
-**[Classification method 3]
-OR
-*Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
-OR
-*If the staging system involves specific and characteristic findings and features:
-*According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
-OR
-*The staging of [malignancy name] is based on the [staging system].
-OR
-*There is no established system for the staging of [malignancy name].
 ==References==

Pancoast tumor classification: Difference between revisions

Latest revision as of 17:55, 15 March 2018

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References

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