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Resectable stage III lung cancer: CT, surgical, and pathologic correlation
I R Scott1, N L Müller, R R Miller
1Department of Radiology, Vancouver General Hospital, British Columbia, Canada.
Radiology
|January 1, 1988
Summary
The new International Staging System aids in identifying stage III lung cancer patients benefiting from surgery. Computed tomography (CT) has limitations in assessing tumor extension, but this doesn't always prevent complete resection or surgery.
Area of Science:
- Thoracic Surgery
- Diagnostic Imaging
- Oncology
Background:
- The International Staging System is a new classification for lung cancer.
- Stage III lung cancer patients may have improved survival after surgical resection.
- Accurate staging is crucial for treatment planning in lung cancer.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) in assessing resectable stage IIIa lung cancer.
- To correlate CT findings with surgical and pathological outcomes.
- To understand the role of CT in identifying patients suitable for surgical resection under the new staging system.
Main Methods:
- Retrospective review of 26 patients with completely resected stage IIIa lung cancer.
- Analysis of preoperative computed tomographic (CT) scans.
- Comparison of CT findings with surgical and pathological data.
Main Results:
- CT demonstrated limited accuracy in detecting chest wall invasion (2/10) and pericardial involvement (1/3).
- CT identified tumor extension near the tracheal carina in only 1 of 3 patients.
- CT showed ipsilateral mediastinal (N2) disease in 11/26 patients, with 8/11 having nodes >10 mm.
Conclusions:
- CT has limitations in assessing tumor extension to the chest wall, mediastinum, pleura, or pericardium.
- Tumor extension or ipsilateral node involvement does not necessarily preclude complete resection or surgery.
- Familiarity with the International Staging System and resectable disease criteria is essential for interpreting CT findings.