Abstract

Initial staging of lung cancer is of major importance for an optimal management and for prognosis evaluation. CT is the first imaging modality for identifying evident metastatic stages or bulky nodal involvement. For other cases, PET CT plays a major role for nodal staging, with the need to obtain a histological confirmation if it changes the therapeutic strategy. This is the same for single metastasis, if technically possible. The 8th edition of the TNM classification is now to be used in clinical routine. Most changes concern the T status, where the prognostic role of tumor size is increased. Every centimeter up to 5cm is now taken into account, and tumors of more than 5 or 7cm are now respectively classified as T3 and T4. There are no major changes regarding the N status. A distinction is made between single (M1b) versus multiple (M1c) extrathoracic metastasis in view of their different prognosis.

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