themag62
![]()
Posts:2
In general, what is the minimum level of tumor (<3 centimeter adenocarcinoma) extension to the pleura that qualifies as a stage T2? If the tumor reaches the pleura does that usually mean it has "invaded" the pleura? Are there any meaningful distinctions or levels of pleural involvement for staging? (Assume all nodes are negative).
Did a search but can't find anything on here relevant.
Thanks!
Forums
Reply # - January 22, 2014, 04:07 PM
Reply To: The Pleura and Staging
Hello,
If you look at the detailed staging information from the National Cancer Institute, you can see that pleural involvement is stage I unless other factors are present, such as nodal involvement or a large primary tumor. Here is the description for stage II:
"(1) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:
The tumor is not larger than 5 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.
or
(2) Cancer has not spread to lymph nodes and one or more of the following is true:
The tumor is larger than 5 centimeters but not larger than 7 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus." - http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/Pa…
--------
Since the pleura is a thin membrane, either the cancer has reached only its innermost layer or has gone beyond it and it's no longer just pleural involvement. So unless one or more of the factors listed in (2) is present, the cancer you describe is likely stage I.
JimC
Forum moderator
Reply # - January 22, 2014, 08:49 PM
Reply To: The Pleura and Staging
As Jim noted, there are actually grades of pleural involvement, so you'd need to clarify that to define the T (tumor) stage optimally. The pathology report should specify the extent of pleural involvement/invasion, or you can ask the surgeon, oncologist, or a pathologist for classification. Many pathology reports will distill the report down to a stage by the standard TNM (tumor, nodes, metastases) system.
Good luck.
-Dr. West