imal than the lobar bronchus.
- T2: Tumour with any of the following features:
- >3cm in greatest dimension
- Involves main bronchus, 2cm or more distal to the carina
- Invades visceral pleura
- Associated with atelectasis or obstructive pneumonitis, extending to the hilar region but not involving the entire lung.
- T3: Tumour of any size,
- directly invading the chest wall, diaphragm, mediastinal pleura or parietal pericardium; or tumour in the main bronchus; or
- in the main bronchus, less than 2cm distal to the carina, but without involvement of the carina; or
- with associated atelectasis or obstructive pneumonitis of the entire lung
- T4: Tumour of any size, invading the mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or with separate tumour nodules in one lobe, or with malignant pleural effusion
- Regional lymph nodes (N):
- NX: Regional lymph nodes not able to be assessed
- N0: No regional lymph node metastasis
- N1: Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension
- N2: Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes
- N3: Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes
- Distant Metastasis (M)
- MX: Distant metastasis not able to be assessed
- M0: No distant metastasis
- M1: Distant metastasis, including separate tumour nodule(s) in a different lobe (ipsi- or contralateral).
Using this classification, non-small cell lung cancers are grouped into stages as follows:
- Stage 0: TIS N0 M0
- Stage Ia: T1 N0 M0
- Stage Ib: T2 N0 M0
- Stage IIa: T1 N1 M0
- Stage IIb: T2 N1 M0, T3 N0 M0
- Stage IIIa: T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0
- Stage IIIb: any T N3 MO, T4 any N M0
- Stage IV: any T any N M1
Using this system, outcomes are best for patients with early stages of disease, with small tumours, no spread to lymph nodes, and no distant spread (metastasis) to other organs. Outcomes are also better for younger patients.
Overall, despite treatment, 5-year survival for all types of lung cancer in Australia is not good: 11% for males and 14% for females. Survival for large cell carcinoma is poorer than that for squamous cell carcinoma and adenocarcinoma, though better than for small cell carcinoma. One estimate places 5-year survival for large cell carcinoma at 11%.
How is Lung Cancer (Large Cell Carcinoma of the Lung) Treated?
- Surgery offers the best chance of cure, but is usually only possible with small tumours that have not yet spread (stage I or II). In some cases, lobectomy may be more appropriate than limited resection.
- If surgical treatment is to be given, the lymph nodes draining the tumour should be sampled and removed if the cancer has spread.Radiotherapy:
- Patients with tumours which are not suitable for surgical resection can benefit from radiotherapy to the chest.
- Patients with early disease (Stage I or II cancer) who have had the tumour completely surgically removed do not usually need radiotherapy.
- Chemotherapy can increase survival for patients with advanced cancer who are otherwise medically fit. Chemotherapy may also have improve quality of life for these patients.
- If chemotherapy is to be used, combination regimes (using more than one drug together) are better than single-drug regimes. Chemotherapy using platinum-based drugs produces the best results.
New classes of treatment agents, such as biological therapies, are finding a place alongside chemotherapy. Watch this site for breaking news regarding this treatment.
Lung symptoms commonly reported by patients with incurable lung cancer include shortness of breath from pleural effusion, coughing, or haemoptysis (coughing up blood). Pain may be from the lung tumour itself, or from spread (metastasis) to other organs, including bone. Treatment is available for all of these symptoms. In some cases, radiotherapy may be used to manage cancer pain.
Spinal cord compression is a complication of cancer spread to the spine 