Why should lung cancer patients undergo TNM staging?

*Only for medical professionals' reference.
Lung cancer is the malignant tumor with the highest mortality rate among men and women in China
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Once the pathological type of lung cancer is confirmed, the factors that have the greatest impact on survival are the staging and treatment of the cancer.
The clinical practice guidelines depend to a large extent on the staging model
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Lung cancer staging is not only used to predict the prognosis of the disease (survival time after treatment), but also to guide treatment
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TNM staging is the most commonly used staging method for doctors to treat non-small cell lung cancer, and sometimes it is also used for small cell lung cancer
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The three letters represent the three dimensions, T is the size of the primary tumor, N is for lymph node metastasis, M is for distant metastasis of cancer, and the number after each letter represents the specific degree, TNM three This dimension is an important factor in determining the prognosis of lung cancer
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Before lung cancer treatment, after a systematic evaluation, a clinical TNM staging will be made.
The doctor will choose the most suitable treatment plan based on this staging, whether it is surgery, chemotherapy, or concurrent radiotherapy and chemotherapy.
All of these will be based on TNM.
To be determined by installments
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Regarding the treatment effect that everyone is concerned about, TNM staging can also be estimated before treatment.
The higher the stage, the treatment effect will be inferior to the lower stage.
Although it is not a 100% curative effect judgment index, it is also an important index for reference.
One
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The middle of the 20th century was the early stage of the formation of TNM classification.
At that time, surgery was the main method of tumor treatment, and even the only method.
TNM staging was mainly formulated to adapt to surgical treatment at the beginning
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Therefore, for the first diagnosed lung cancer patients and their families, the most important decision is: do we have indications for surgery?
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According to the international common clinical staging of lung cancer [1], lung cancer is divided into stage I (stage I lung cancer is divided into stage IA and stage IB); stage II (stage II lung cancer is divided into stage IIA and IIB); stage III (stage III lung cancer is divided into Stage IIIA and IIIB); Stage IV lung cancer
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This is what we often call the early, middle and late stages
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Stage IIIB/IV lung cancer usually has no indications for surgery.
We can compare the TNM staging table of lung cancer to determine the clinical stage
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International Association for the Study of Lung Cancer (IASLC) 7th edition lung cancer staging system I-IIIA stage lung cancer has the opportunity of surgery, but the 5-year survival rate of patients with different stages is still very different, and many patients will experience recurrence after surgery
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Stage IA lung cancer only occurs in the lungs.
Surgery is usually the main treatment.
The chance of recurrence or metastasis after surgery is low.
You can choose not to receive adjuvant treatment
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For stage IB-IIIA lung cancer, perioperative chemotherapy can only increase the survival rate by 5.
4%, and the side effects are relatively large.
More than 60% of patients will have grade 3 or above toxic side effects
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Patients with stage IB-IIIA EGFR mutation-positive NSCLC who receive osimertinib adjuvant therapy after complete resection have been recommended by the latest authoritative international guidelines (NCCN guidelines [2])
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Reference: [1]Detterbeck FC et al.
The Eighth Edition Lung Cancer Stage Classification.
Chest.
2017;151(1):193-203.
[2]NCCN Guidelines Version 4.
2021: Non-small cell lung cancer.
Expert profile Liang Junguo Chief Physician, PhD, Master Supervisor
.

Deputy Director of Thoracic Surgery, Affiliated Hospital of Inner Mongolia Medical University Member of the Esophageal Cancer Group of the Chinese Medical Association Thoracic Surgery Branch Member of the Lung Cancer Professional Committee of the Chinese Anti-Cancer Association Member of the Standing Committee of the Thoracic Surgery Branch of the Inner Mongolia Medical Association No.
CN-85217 Expiration date 2021-12-10* The copyright of this article belongs to the original author.
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