systematic diagnosis and staging of non-small cell lung cancer · jamal. ca cancer j clin 2011....
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Jamal. CA Cancer J Clin 2011. Lewis. SEER Cancer Statistics Review, 1975-2008. 2010.
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Goldstraw. J Thorac Oncol 2007.
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Detterbeck. Chest 2013.
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Mass
N1 N2
N2
N3
N3
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Detterbeck. Chest 2013.
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Detterbeck. Chest 2009.
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Overall Stage Treatment Median 5 year Survival
Stage I Surgical resection or localized radiation for curative
intent
61%
Stage II Surgical resection or localized radiation, followed by systemic
therapy for curative intent
38%
Stage III Systemic therapy and radiation, possibly followed by surgery for
curative intent
23%
Stage IV Systemic therapy or hospice 4%
Lewis. SEER Cancer Statistics Review, 1975-2008. 2010. Goldstraw. J Thorac Oncol 2007.
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Silvestri. Chest 2013.
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Fischer. NEJM 2009.
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Detterbeck. Chest 2009.
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Silvestri. Chest 2013.
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Detterbeck. Chest 2009.
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Herth. Eur Respir J 2006. Herth. Chest 2008.
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Saettele. Respirology 2014.
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Yasafuku. Chest 2006.
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Yasafuku. Lung Cancer 2005.
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Almeida. Chest 2013.
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Swensen. Arch Intern Med 1997.
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http://www.chestx-ray.com/index.php/calculators/spn-calculator
Swensen. Arch Intern Med 1997.
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0 0.2 0.4 0.6 0.8 1
Observation with serial CT Further Testing Surgical Resection
Observation–Test Threshold
Test-Treat Threshold
Patient desires certainty
Patient averse to surgery High risk of surgery
Probability of Lung Cancer Ost. Am J Respir Crit Care Med 2012.
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Silvestri. Chest 2013. Ost. Am J Respir Crit Care Med 2012.
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0 0.2 0.4 0.6 0.8 1
Observation with serial CT Further Testing Surgical Resection
Observation–Test Threshold
Test-Treat Threshold
Probability of Lung Cancer
Positive PET-CT
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0 0.2 0.4 0.6 0.8 1
Observation with serial CT Further Testing Surgical Resection
Observation–Test Threshold
Test-Treat Threshold
Probability of Lung Cancer
Negative PET-CT
Consider Biopsy
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Saettele. Respirology 2014.
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