Principles of Cancer Staging

  • Paul BaasEmail author


Staging is the process to group patients with more or less similar disease, prognosis, and possible response to a certain therapy. It allows us to compare different therapies within similar groups. Clinical staging consists of physical examination, radiological evaluation, laboratory testing, and recently the use of minimally invasive techniques.

PET/CT scanning has now obtained a firm place in this process and is considered to be cost-effective. A more recent development is the use of the minimally invasive techniques like endobronchial ultrasound (EBUS) and endo-esophageal ultrasound (EUS). They contribute significantly to the staging process and improve the selection of patients for studies or local treatments like chemoradiotherapy. In addition, the indication for surgical techniques (thoracoscopy and mediastinoscopy) is also reviewed. The use of the seventh international staging system and the impact of the new techniques are discussed in this chapter.


Small Cell Lung Cancer Malignant Pleural Effusion Large Cell Carcinoma Endobronchial Ultrasound Pleural Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. 1.
    Jeman A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96.CrossRefGoogle Scholar
  2. 2.
  3. 3.
    Travis WD, Muller-Hermelink HK, Harris CC, et al. Pathology and genetics of tumours of the lung, pleura, thymus and heart. In: World Health Organization, editor. World Health Organization classification of tumours: pathology and genetics. Lyon: IARC Press/WHO Blue Books; 2004.Google Scholar
  4. 4.
    Rami-Porta R, Bill D, Crowley J, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007;2:593–602.PubMedCrossRefGoogle Scholar
  5. 5.
    Rusch VR, Crowley J, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007;2:603–12.PubMedCrossRefGoogle Scholar
  6. 6.
    IASLC Staging Handbook. In: Thoracic malignancies. 7th ed. 2009. Editor and Publisher Deb Whippen, Florida: Editorial Rx Press, ISBN 978-0-9799274-2-3.Google Scholar
  7. 7.
    Lardinois D, Weder W, Hany TF, et al. Staging of non-small cell lung cancer with integrated positron-emission-tomography and computed tomography. N Engl J Med. 2003;348:2500–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Cerfolio RJ, Ohja B, Bryant AS, et al. The accuracy of integrated PET-CT compared with dedicated PET alone for the staging of patients with non-small cell lung cancer. Ann Thor Surg 2004;78:1017–23.CrossRefGoogle Scholar
  9. 9.
    Halpern BS, Schiepers C, Weber WA, et al. Presurgical staging of non-small cell lung cancer: positron emission tomography, integrated positron tomography/CT, and software image fusion. Chest. 2005;128:2289–97.PubMedCrossRefGoogle Scholar
  10. 10.
    De Wever W, Ceyssens S, Mortelmans L, et al. Additional value of PET-CT in the staging of lung cancer: comparison with CT alone, PET alone and visual correlation of PET and CT. Eur Radiol. 2007;17:23–32.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Thoracic OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands

Personalised recommendations