[Lung tumors: symptoms, clinical signs, evaluation and staging]

The signs and symptoms of the predominantly malignant lung tumors primarily depend on the site and the local infiltration of the tumor as well as on the extent of metastatic dissemination and the paraneoplastic syndromes. The investigation--mainly on an outpatient basis--includes three phases. The first step is the cytological and/or histological identification of the tumor, usually by means of chest X-ray, sputum examination, bronchoscopy or more invasive methods. Beginning with computed tomography, the goal of the second step is the staging of the extent of the disease. Patients with small-cell lung cancer [SCLC], which is considered to be primarily nonresectable, are classified as having either limited or extensive disease. A survival difference has been reported between the two stages. In order to define the potentially resectable forms [25%] of non-small-cell lung cancer [NSCLC], the TNM classification is applied. Finally, it has to be estimated whether the patient is fit for major surgery.