Small cell lung cancer: Difference between revisions

Latest revision as of 13:27, 5 January 2024

Background

A form of lung cancer that is almost exclusively in smokers, particularly in heavy smokers

Risk Factors

Tobacco smoking
Second-hand smoke
Asbestos exposure
Radon exposure

Clinical Presentation

May be detected in asymptomatic patients as an incidental finding
Potential symptoms include cough, dyspnea, weight loss, and functional decline
On imaging, there is most commonly a central, hilar mass with bulky mediastinal lymphadenopathy
About 70% have metastatic disease at presentation, including liver, adrenal glands, bone, bone marrow, and brain

Staging

TMN

Stage 1: a single lesion ≤3 cm with no lymphadenopathy
Stage 2: ipsilateral lymph nodes and mediastinum
Stage 3: contralateral lymph nodes and metastases
Stage 4: distant metastases

VALSG

Limited stage: disease confined to ipsilateral lung, lymph nodes, and mediastinum, which can be contained within one radiotherapy window
Extensive stage: metastasis to contralateral lung, contralateral lymph nodes, or distant sites

Management

Stage 1

Potentially curative
Surgical resection
- If lymph nodes negative, adjuvant chemotherapy
- If lymph nodes positive, adjuvant chemoradiotherapy
The adjuvant chemotherapy is platinum-based

Stage 2/Limited Stage

Not curative
Early chemoradiotherapy

Stage 3 or 4/Extensive Stage

Not curative
Chemotherapy extends median survival from 3 months to 8 to 13 months
Prophylactic cranial irradiation

@@ Line 1: / Line 1: @@
-== Staging (TMN) ==
+== Background ==
+* A form of [[lung cancer]] that is almost exclusively in smokers, particularly in heavy smokers
-* Stage 1: a single lesion ≤3 cm with no lymphadenopathy
-* Stage 2: ipsilateral lymph nodes and mediastinum
-* Stage 3: contralateral lymph nodes and metastases
-* Stage 4: distant metastases
-== Staging (VALSG) ==
+=== Risk Factors ===
+* '''Tobacco smoking'''
-* ''Limited stage:'' disease confined to ipsilateral lung, lymph nodes, and mediastinum, which can be contained within one radiotherapy window
+* Second-hand smoke
-* ''Extensive stage:'' metastasis to contralateral lung, contralateral lymph nodes, or distant sites
+* Asbestos exposure
+* Radon exposure
-== Management ==
+== Clinical Presentation ==
+* May be detected in asymptomatic patients as an incidental finding
-=== Stage 1 ===
+* Potential symptoms include cough, dyspnea, weight loss, and functional decline
+* On imaging, there is most commonly a central, hilar mass with bulky mediastinal lymphadenopathy
+* About 70% have metastatic disease at presentation, including liver, adrenal glands, bone, bone marrow, and brain
+==Staging==
-* Potentially curative
+===TMN===
-* Surgical resection
-** If lymph nodes negative, adjuvant chemotherapy
-** If lymph nodes positive, adjuvant chemoradiotherapy
-* The adjuvant chemotherapy is platinum-based
+*Stage 1: a single lesion ≤3 cm with no lymphadenopathy
-=== Stage 2/Limited Stage ===
+*Stage 2: ipsilateral lymph nodes and mediastinum
+*Stage 3: contralateral lymph nodes and metastases
+*Stage 4: distant metastases
+===VALSG===
-* Not curative
-* Early chemoradiotherapy
+*''Limited stage:'' disease confined to ipsilateral lung, lymph nodes, and mediastinum, which can be contained within one radiotherapy window
-=== Stage 3 or 4/Extensive Stage ===
+*''Extensive stage:'' metastasis to contralateral lung, contralateral lymph nodes, or distant sites
+==Management==
-* Not curative
-* Chemotherapy extends median survival from 3 months to 8 to 13 months
+===Stage 1===
-* Prophylactic cranial irradiation
+*Potentially curative
+*Surgical resection
+**If lymph nodes negative, adjuvant chemotherapy
+**If lymph nodes positive, adjuvant chemoradiotherapy
+*The adjuvant chemotherapy is platinum-based
+===Stage 2/Limited Stage===
+*Not curative
+*Early chemoradiotherapy
+===Stage 3 or 4/Extensive Stage===
+*Not curative
+*Chemotherapy extends median survival from 3 months to 8 to 13 months
+*Prophylactic cranial irradiation
 [[Category:Respirology]]