Nsclc

Front 1

Which patients are suitable for pneumonectomy?

Back 1

FEV1 >1.2 L and

- NO hypercarbia
- NO cor pulmonale

Front 2

Which study established lobectomy as the standard of care for early stage lung cancer?

Back 2

Lung Cancer Study Group 821 (Ginsberg 1995)

Front 3

T1

Back 3

≤3 cm and surrounded by lung

T1a: ≤2 cm

T1b: 2.1-3cm

Front 4

T2

Back 4

1. >3 and ≤7 cm
2. Involves main bronchus ≥2 cm from the carina
3. Invades visceral pleura
4. Atelectasis or obstructive pneumonitis extending to the hilum

T2a: >3-5 cm

T2b: >5-7 cm

Front 5

T3

Back 5

1. >7 cm
2. Invades main bronchus <2cm from carina
3. Invades parietal pleura, mediastinal pleura, parietal pericardium, chest wall, phrenic nerve or diaphragm
4. Atelectasis or obstructive pneumonitis of the entire lung
5. Separate tumor nodules in the same lobe

Front 6

T4

Back 6

Any size:

1. Invades carina
2. Invades mediastinum, heart, great vessels, tracheal, recurrent laryngeal nerve, esophagus, vertebral body
3. Separate tumor nodules in a different ipsilateral lobe

Front 7

N1

Back 7

Double digit nodes i.e.

• Ipsilateral peribronchial
• Ipsilateral hilar
• Intrapulmonary

Front 8

N2

Back 8

Single digit nodes i.e.

• Ipsilateral mediastinal
• Subcarinal (level 7)

Front 9

N3

Back 9

Contralateral mediastinal

Contralateral hilar

Any scalene

Any supraclavicular

Front 10

M1a

Back 10

1. Separate tumor nodule in the contralateral lung
2. Malignant pleural or pericardial effusion
3. Pleural nodules

Front 11

M1b

Back 11

All other distant disease

Front 12

Workup for NSCLC

Back 12

Complete H&P (weight loss, smoking)

CT chest to include adrenals

CBC

CMP

MRI if paraspinal or superior sulcus

MRI brain above stage II

Mediastinoscopy or EBUS for N2 nodes

PFTs

Smoking cessation

Front 13

What is considered early stage NSCLC?

Back 13

Stage I and II e.g.

T1a-bN0-1

T2a-bN0-1

T3N0

Front 14

What is the only way to assess stations 5-6?

Back 14

VATS surgery or anterior mediastinoscopy (Chamberlain procedure)

Front 15

When is mediastinal nodal assessment required?

Back 15

Confirm CT or PET+ nodes

Superior sulcus tumor

T3 or central T1-2