Skip to content

Lung Cancer Health Center

Font Size

Small Cell Lung Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Small Cell Lung Cancer

Staging Systems

Several staging systems have been proposed for small cell lung cancer (SCLC). These staging systems include the following:

Recommended Related to Lung Cancer

Lung Cancer Resources

The National Comprehensive Cancer Network is a nonprofit alliance of 21 cancer centers throughout the U.S. that treat all cancers. National Comprehensive Cancer Network  

Read the Lung Cancer Resources article > >

  • American Joint Committee on Cancer (AJCC) Tumor, Node, and Metastasis (TNM).[1]
  • Veterans Administration Lung Study Group (VALG).[2]
  • International Association for the Study of Lung Cancer (IASLC).[3]

Limited-Stage Disease

No universally accepted definition of this term is available. Limited-stage disease (LD) SCLC is confined to the hemithorax of origin, the mediastinum, or the supraclavicular nodes, which can be encompassed within a tolerable radiation therapy port.

Patients with pleural effusion, massive pulmonary tumor, and contralateral supraclavicular nodes have been both included within and excluded from LD by various groups.

Extensive-Stage Disease

Extensive-stage disease (ED) SCLC has spread beyond the supraclavicular areas and is too widespread to be included within the definition of LD. Patients with distant metastases (M1) are always considered to have ED.[3,4]

IASLC-AJCC TNM Staging System

The AJCC TNM defines LD as any T, except for T3-4, due to multiple lung nodals that do not fit in a tolerable radiation field, any N, and M0.[1] This corresponds to TNM stages I to IIIB. Extensive disease is TNM stage IV with distant metastases (M1) including malignant pleural effusions.[3,4]

The IASLC conducted an analysis of clinical TNM staging for SCLC using the sixth edition of the AJCC TNM staging system for lung cancer. Survivals for patients with clinical stages I and II disease are significantly different from those for patients with stage III disease with N2 or N3 involvement.[3] Patients with pleural effusion have an intermediate prognosis between LD and ED with hematogenous metastases and will be classified as having M1 disease (or ED). Application of the TNM system will not change how patients are managed; however, the analysis suggests that, in the context of clinical trials in LD, accurate TNM staging and stratification may be important.[3]

Staging Evaluation

Staging procedures for SCLC are important in distinguishing patients with disease limited to their thorax from those with distant metastases. At the time of initial diagnosis, approximately two-thirds of patients with SCLC have clinical evidence of metastases; most of the remaining patients have clinical evidence of extensive nodal involvement in the hilar, mediastinal, and sometimes supraclavicular regions.

Determining the stage of cancer allows an assessment of prognosis and a determination of treatment, particularly when chest radiation therapy or surgical excision is added to chemotherapy for patients with LD. If ED is confirmed, further evaluation should be individualized according to the signs and symptoms unique to the individual patient. Standard staging procedures include the following:

1|2
Next Article:

Today on WebMD

Broken cigarette
Do you know the myths from the facts?
man with a doctor
Our health check will steer you in the right direction.
 
sauteed cherry tomatoes
Fight cancer one plate at a time.
Lung cancer xray
See it in pictures, plus read the facts.
 
15 Cancer Symptoms Men Ignore
FEATURE
Lung Cancer Risks Myths and Facts
SLIDESHOW
 
cancer fighting foods
SLIDESHOW
Improving Lung Cancer Survival Targeted Therapy
VIDEO
 
Lung Cancer Surprising Differences Between Sexes
VIDEO
Pets Improve Your Health
SLIDESHOW
 
Vitamin D
SLIDESHOW
Lung Cancer Surgery Options
VIDEO
 

WebMD Special Sections