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Types of Cancer > Lung Cancer > Diagnosis, Screening, and Staging
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| Cancer Stage Information |
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Stage Information
Since determination of stage has important therapeutic and prognostic implications, careful initial diagnostic evaluation to define location and extent of primary and metastatic tumor involvement is critical for the appropriate care of patients.
Stage has a critical role in the selection of therapy. The stage of disease is based on a combination of clinical (physical examination, radiologic, and laboratory studies) and pathologic (biopsy of lymph nodes, bronchoscopy, mediastinoscopy, or anterior mediastinotomy) factors. The distinction between clinical stage and pathologic stage should be considered when evaluating reports of survival outcome. Surgical staging of the mediastinum is considered standard if accurate evaluation of the nodal status is needed to determine therapy. The Radiology Diagnostic Oncology Group reported that the sensitivity and specificity of computed tomographic (CT) scanning is only 52% and 69%, respectively. Magnetic resonance imaging does not appear to improve the accuracy of staging. Early evaluation of the role of positron emission tomography (PET) suggests that the combination of CT and PET may have greater sensitivity and specificity than CT alone. A report evaluating the staging of 1,400 patients undergoing tumor resection found that clinical staging by radiologic studies accurately assessed the T stage in 78% of patients and the N stage in only 47% of patients. Errors in clinical staging were equally divided between overstaging and understaging.
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SOURCE: National Cancer Institute
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