Non-Small Cell Lung Cancer (NSCLC) • Slower, more indolent (possible asymptomatic) • More often peripheral lung • Smoking hx is less important • TNM (tumour size; node involvement, metastasis): I to IV • Prognosis: curative if caught early • 35-40% (5 year survival) • Stage 1: 80-90% cure • Stage 3/4: 15-20% cure
| **Non-small Cell Lung Cancer (NSCLC)**from other cells· Adenocarcinoma· Squamous cell carcinoma (SCC) → 🚬Smoking · Carcinoid· Large cell | ||
|---|---|---|
| Presentation | Constitutional symptoms: fever, night sweat, weightless Intrathoracic effects: cough, hemoptysis, chest pain, dyspnea, or hoarseness, Extra thoracic effects: (SCC): grows at apex, compresses blood vessels and nerves. · Pancoast syndrome (pain in shoulder, forearm, scapula, finger)· Horner syndrome (ipsilateral SNS loss) Bony metastasis in 20% of initial presentation. | |
| Staging | TNM staging – clinical staging (I – IV) · stage I, II, or III NSCLC are treated with the intent to cure.· stage IV – non-curable. Stage I, II are given pathologic stage after surgical resection for surveillance/ adjuvant chemotherapy. | |
| Prognosis | Prognosis is generally better than SCLC. The prognosis of NSCLC is dependent on the TNM staging, and the performance status/comorbidities of the patient.Poor prognostic factors:· poor performance · Poor appetite· weight loss · Lymphatic vessel invasion, occult lymph node metastasis. · Metabolic activity on PET scan. Recurrence after complete resection has been cited at 41 percent, with the median time to recurrence at 11.5 months and median survival of 8.1 months. |