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{{familytree/start}}
{{familytree | | | | F01 | | | | | | | | F02 | | | | | | | | | F03 | | | | | | | | | | | | | F01=Superior suculus tumor|F02=Preferred option: Surgery + pathological determination of microscopic residual tumor|F03=Neoadjuvant Chemotherapy <br>OR<br>Chemotherapy + radiation therapy}}
{{familytree | | | | | | | | A01 | | | | | | | | | A01=Is pleural o pericardial effusion present (suggestive of M1a) or are findings suggestive of systemic metastasis (M1b) present?}}
{{familytree | | | | |!| | | | | | | | | |!| | | | | | | | | | |!| | | | | | | | | | | | | | | |}}
{{familytree | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | |}}
{{familytree | | | | G01 | | | | | | | | G02 | | | | | | | | | G03 | | | | | | | | | | | | | | | G01=<div style="float: left; text-align: left; width: 14em; padding:1em;">Is the tumor larger than 7 cm or invaded adjacent structures (T3) with or without invasion of ipsilateral peribronchial or hiliar nodes (N1)? <br>OR<br> Has the tumor has estended to any of the following:
{{familytree | | | B01 | | | | | | | | B02 | | | | | B01=M1a|B01=M1b}}
* Carina<br>
{{familytree | | | |!| | | | | | | | | |!| | | | | | |}}
* Esophagus<br>
{{familytree | | | C01 | | | | | | | | C02 | | | | | | C01=Perform the following tests:<br>
* Great vessels<br>
* Perform thoracentesis and/or pericardiocenteis<br>
* Heart<br>
* Perform a thoracoscopy if thoracocentesis is inconclusive
* Laryngeal nerve<br>
|C02=Perform the following tests:<br>
* Mediastinum<br>
* Brain MRI<br>
* Trachea<br>
* Bronchoscopy<br>
* Nodules in a different ipsilateral lobe
* Mediastinal lymph node biopsy<br>
</div>|G02=Are margins from the surgical piece positive or negative for residual tumor?|G03=Perform surgery + pathological determination of residual tumor}}
* If not previously done, PET scan or CT scan}}
{{familytree | |,|-|-|^|-|-|.| | | |,|-|-|^|-|-|.| | | | | | | |!| | | | | | | | | |}}
{{familytree | | | |!| | | | | | | | | |!| | | | | | | |}}
{{familytree | H01 | | | | H02 | | H03 | | | | H04 | | | | | | H05 | | | | | | | | H01=T3, N0-1|H02=T4|H03=Negative (R0)|H04=Positive: Is the residual tumor microscopic (R1) or macroscopic (R2)|H05=Are margins from the surgical piece positive or negative for residual tumor?}}
{{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 | I01 | | | | I02 | | I03 | | I04 | | I05 | | I06 | | I07 | | | | | | | | | | I01=Initiate neoadjuvant chemotherapy + radiation therapy|I02=Is the tumor resectable?|I03=Adjuvant chemotherapy|I04=Microscopic (R1)|I05=Macroscopic (R2)|I06=Negative (R1)|I07=Positive (R1-2)}}
{{familytree | E01 | | E02 | | E03 | | | | | | E04 | | | | E01=Yes|E02=No|E03=Adrenal|E04=Brain}}
{{familytree | |!| | | |,|-|^|-|.| | | | | |!| | | |!| | | |!| | | |!| | | | | |}}
{{familytree | |!| | | |!| | | |!| | | | | | | |!| | | | | | |}}
{{familytree | J01 | | J02 | | J03 | | | | J04 | | J05 | | J06 | | J07 | | | | | | | | | | | | J01=Surgery + adjuvant [[chemotherapy]]|J02=Yes|J03=No|J04=Tumor resection + adjuvant chemotherapy<br>OR<br>Chemotherapy + radiotherapy|J05=Tumor resection + adjuvant chemotherapy<br>OR<br>Chemotherapy + radiotherapy|J06=Observation|J07=Tumor resection}}
{{familytree | F01 | | F02 | | F03 | | | | | | F04 | | | | | F01=Local therapy<br>
{{familytree | | | | | |!| | | |!| | | | | | | | | | | | | | | | | | | | | | | | | |}}
* Ambulatory catheter drainage<br>
{{familytree | | | | | K01 | | K02 | | | | | | | | | | | | | | | | | | | | | K01=Initiate neoadjuvant chemotherapy + radiation therapy|K02=Initiate definitive chemotherapy + radiation therapy}}
* Pleurodesis<br>
{{familytree | | | | | |!| | | | | | | | | | | | | | | |}}
* Mediastinal window
{{familytree | | | | | L01 | | | | | | | | | | | | | | | | L01=Perform a surgical evaluation: Is the tumor resectable?}}
<br>PLUS<br>
{{familytree | | |,|-|-|^|-|-|.| | | | | | | |}}
Therapy for metastatic disease (click here for the treatment of local and systemic metastasis and neoplastic recurrence)
{{familytree | | M01 | | | | M02 | | | | | | | | | | M01=Yes|M02=No}}
|F02=Treat according to tumor stage:<br>
{{familytree | | |!| | | | | |!| | | | | | | | | | |}}
* [[Non small cell carcinoma of the lung medical therapy#Stage I|I]]<br>
{{familytree | | N01 | | | | N02 | | | | | | | | | | N01=Tumor extraction + adjuvant chemotherapy|N02=Definitive chemotherapy + radiation therapy}}
* [[Non small cell carcinoma of the lung medical therapy#Stage II|II]]<br>
* [[Non small cell carcinoma of the lung medical therapy#Stage III|III]]<br>
|F03=Perform a needle aspiration biopsy|F04=Surgical resection + adjuvant radiation therapy<br>Radiation therapy alone:<br>* Sterotactic radio surgery + Whole brain radiation therapy<br>OR<br>* Sterotactic radio surgery alone|
{{familytree/end}}
{{familytree/end}}

Revision as of 14:47, 19 June 2014

{{familytree | F01 | | F02 | | F03 | | | | | | F04 | | | | | F01=Local therapy

  • Ambulatory catheter drainage
  • Pleurodesis
  • Mediastinal window


PLUS
Therapy for metastatic disease (click here for the treatment of local and systemic metastasis and neoplastic recurrence) |F02=Treat according to tumor stage:

|F03=Perform a needle aspiration biopsy|F04=Surgical resection + adjuvant radiation therapy
Radiation therapy alone:
* Sterotactic radio surgery + Whole brain radiation therapy
OR
* Sterotactic radio surgery alone|

 
 
 
 
 
 
 
Is pleural o pericardial effusion present (suggestive of M1a) or are findings suggestive of systemic metastasis (M1b) present?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
M1b
 
 
 
 
 
 
 
{{{ B02 }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Perform the following tests:
  • Perform thoracentesis and/or pericardiocenteis
  • Perform a thoracoscopy if thoracocentesis is inconclusive
 
 
 
 
 
 
 
Perform the following tests:
  • Brain MRI
  • Bronchoscopy
  • Mediastinal lymph node biopsy
  • If not previously done, PET scan or CT scan
  •  
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
    Is the liquid extracted positive for malignant cells?
     
     
     
     
     
     
     
    Are findings suggestive of adrenal metastasis or brain metastasis?
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
    Yes
     
    No
     
    Adrenal
     
     
     
     
     
    Brain