SandboxAlonso: Difference between revisions
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{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | | | | | A01 | | | | | A01=Is pleural | {{familytree | | | | | | | A01 | | | | | A01=Is [[Pleural effusion|pleural]] or [[pericardial effusion]] present (suggestive of M1a) or are findings suggestive of systemic [[metastasis]] (M1b) present?}} | ||
{{familytree | | | |,|-|-|-|^|-|-|-|.| | |}} | {{familytree | | | |,|-|-|-|^|-|-|-|.| | |}} | ||
{{familytree | | | B01 | | | | | | B02 | B01=M1a|B02=M1b}} | {{familytree | | | B01 | | | | | | B02 | B01=M1a|B02=M1b}} | ||
{{familytree | | | |!| | | | | | | |!| | | |}} | {{familytree | | | |!| | | | | | | |!| | | |}} | ||
{{familytree | | | C01 | | | | | | C02 | | | C01=<div style="float: left; text-align: left; width: 14em; padding:1em;">Perform the following tests:<br> | {{familytree | | | C01 | | | | | | C02 | | | C01=<div style="float: left; text-align: left; width: 14em; padding:1em;">Perform the following tests:<br> | ||
* Perform thoracentesis and/or pericardiocenteis<br> | * Perform [[thoracentesis]] and/or [[pericardiocenteis]]<br> | ||
* Perform a thoracoscopy if thoracocentesis is inconclusive | * Perform a [[thoracoscopy]] if [[thoracocentesis]] is inconclusive | ||
</div>|C02=<div style="float: left; text-align: left; width: 14em; padding:1em;">Perform the following tests:<br> | </div>|C02=<div style="float: left; text-align: left; width: 14em; padding:1em;">Perform the following tests:<br> | ||
* Brain MRI<br> | * [[Brain tumor MRI|Brain MRI]]<br> | ||
* Bronchoscopy<br> | * [[Bronchoscopy]]<br> | ||
* Mediastinal lymph node biopsy<br> | * Mediastinal [[lymph node biopsy]]<br> | ||
* If not previously done, PET scan or CT scan</div>}} | * If not previously done, [[PET scan]] or [[CT scan]]</div>}} | ||
{{familytree | | | |!| | | | | | | |!| | | | |}} | {{familytree | | | |!| | | | | | | |!| | | | |}} | ||
{{familytree | | | D01 | | | | | | D02 | | | | D01=Is the liquid extracted positive for malignant cells?|D02=Are findings suggestive of adrenal metastasis or brain metastasis?}} | {{familytree | | | D01 | | | | | | D02 | | | | D01=Is the liquid extracted positive for malignant cells?|D02=Are findings suggestive of [[adrenal]] metastasis or [[brain]] metastasis?}} | ||
{{familytree | |,|-|^|-|.| | | |,|-|^|-|.| | | |}} | {{familytree | |,|-|^|-|.| | | |,|-|^|-|.| | | |}} | ||
{{familytree | E01 | | E02 | | E03 | | E04 | | | E01=Yes|E02=No|E03=Adrenal|E04=Brain}} | {{familytree | E01 | | E02 | | E03 | | E04 | | | E01=Yes|E02=No|E03=Adrenal|E04=Brain}} | ||
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{{familytree | F01 | | F02 | | F03 | | F04 | | F01=<div style="float: left; text-align: left; width: 14em; padding:1em;">Local therapy<br> | {{familytree | F01 | | F02 | | F03 | | F04 | | F01=<div style="float: left; text-align: left; width: 14em; padding:1em;">Local therapy<br> | ||
* Ambulatory catheter drainage<br> | * Ambulatory catheter drainage<br> | ||
* Pleurodesis<br> | * [[Pleurodesis]]<br> | ||
* Mediastinal window<br> | * Mediastinal window<br> | ||
PLUS<br> | PLUS<br> | ||
| Line 39: | Line 39: | ||
* Radiation therapy<br> | * Radiation therapy<br> | ||
OR<br> | OR<br> | ||
Administer therapy for metastatic disease in case of not curable lung lesions (click here for the treatment of local and systemic metastasis and neoplastic recurrence) | Administer therapy for metastatic disease in case of not curable lung lesions ([[Non small cell carcinoma of the lung medical therapy#Metastatic disease|click here for the treatment of local and systemic metastasis and neoplastic recurrence]]) | ||
</div>|G02=What is the TN stage of the lung tumor?}} | </div>|G02=What is the TN stage of the lung tumor?}} | ||
{{familytree | | | | | | | | | | | |,|-|^|-|.| | |}} | {{familytree | | | | | | | | | | | |,|-|^|-|.| | |}} | ||
| Line 55: | Line 55: | ||
* Neoadjuvant chemotherapy + surgical resection or stereotactic ablative radiation therapy<br>OR<br> | * Neoadjuvant chemotherapy + surgical resection or stereotactic ablative radiation therapy<br>OR<br> | ||
* Stereotactic ablative radiation therpay alone</div> | * Stereotactic ablative radiation therpay alone</div> | ||
|I02=<div style="float: left; text-align: left; width: 14em; padding:1em;">Administer therapy for metastatic disease in case of not curable lung lesions (click here for the treatment of local and systemic metastasis and neoplastic recurrence)</div>}} | |I02=<div style="float: left; text-align: left; width: 14em; padding:1em;">Administer therapy for metastatic disease in case of not curable lung lesions (Non small cell carcinoma of the lung medical therapy#Metastatic disease|click here for the treatment of local and systemic metastasis and neoplastic recurrence)</div>}} | ||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 15:12, 20 June 2014
Stage IV
| Is pleural or pericardial effusion present (suggestive of M1a) or are findings suggestive of systemic metastasis (M1b) present? | |||||||||||||||||||||||||||||||||||||||||||||
| M1a | M1b | ||||||||||||||||||||||||||||||||||||||||||||
Perform the following tests:
| Perform the following tests:
| ||||||||||||||||||||||||||||||||||||||||||||
| Is the liquid extracted positive for malignant cells? | Are findings suggestive of adrenal metastasis or brain metastasis? | ||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | Adrenal | Brain | ||||||||||||||||||||||||||||||||||||||||||
Local therapy
PLUS | Perform a needle aspiration biopsy for metastasis confirmation | Surgical resection + adjuvant radiation therapy Radiation therapy alone:
PLUS | |||||||||||||||||||||||||||||||||||||||||||
If the lung disease is curable, administer therapy for the local adrenal lesion:
OR | What is the TN stage of the lung tumor? | ||||||||||||||||||||||||||||||||||||||||||||
|
| ||||||||||||||||||||||||||||||||||||||||||||
| Administer therapy for metastatic disease in case of not curable lung lesions (Non small cell carcinoma of the lung medical therapy#Metastatic disease | {{{click here for the treatment of local and systemic metastasis and neoplastic recurrence)}}} | |||||||||||||||||||||||||||||||||||||||||||
Metastatic disease
| What the specific subtype according to the specific histological characteristics of the tumor? | |||||||||||||||||||||||||||||||||||||||
| Squamous cell carcinoma | ||||||||||||||||||||||||||||||||||||||
| Perform specific EGFR and ALK mutation testing: What is the specific mutation? | Is the patient smoker or former smoker? | ||||||||||||||||||||||||||||||||||||||
| Sensitizing EGFR mutation | ALK mutation | Negative EGFR and ALK | Click here for the squamous cell carcinoma specific treatment | ||||||||||||||||||||||||||||||||||||
| Click here for the sensitizing EGFR mutation specific treatment | Click here for the specific therapy for the ALK mutation specific treatment | Click here for the treatment of negative sensitizing EGFR and ALK mutation metastatic disease | |||||||||||||||||||||||||||||||||||||