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The Lung Cancer Stage PageLung Cancer Stage Page: There When You Need It—StagingLungCancer.org

Anthony W. Kim, MD, FCCP; Kelsey M. Johnson, PA-C; Frank C. Detterbeck, MD, FCCP
Author and Funding Information

From the Section of Thoracic Surgery (Drs Kim and Detterbeck) and Section of Pulmonary Medicine, Interventional Pulmonology (Ms Johnson), Yale University School of Medicine.

Correspondence to: Anthony W. Kim, MD, FCCP, Section of Thoracic Surgery, Yale School of Medicine, 330 Cedar St, BB 205, New Haven, CT 06520; e-mail: anthony.kim@yale.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts: Dr Detterbeck has received limited compensation for participation in educational activities related to the American Joint Committee on Cancer stage and classification system. Dr Kim and Ms Johnson have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Funding/Support: This Web site development project was supported financially by the American College of Chest Physicians and the Yale Cancer Center. Both organizations also dedicate staff to the development of the project.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(3):581-586. doi:10.1378/chest.11-3192
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Extract

It seems that life gets more and more complicated; this is true as well of the International Union Against Cancer (UICC) and American Joint Committee on Cancer (AJCC) seventh edition of the lung cancer staging system. The increased granularity brought about by the huge increase in the database and the underlying analysis has made the system less intuitive and difficult, if not impossible, to remember.1,2 Both for those who deal with lung cancer occasionally and for focused subspecialists, this increased level of detail represents a challenge. Being correct about the stage is crucial in applying the right data and selecting the optimal treatment for patients. A simple example of the increasing complexity is in the patient with an additional malignant lesion in a different lobe of the ipsilateral chest who, according to the seventh edition lung cancer staging system, will be considered to have a T4 tumor rather than an M1 tumor, as in the sixth edition of the lung cancer staging system. If this patient had no lymph node involvement or disease limited to the ipsilateral chest, this would mean that the patient has a stage IIIA tumor rather than a stage IIIB tumor based on the seventh edition of the lung cancer staging system.

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