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1. CLASSIFICATION AND STAGING OF LUNG CANCER
2. INDEX Relevance WHO classification of tumours of the lung
TNM Lung carcinoma stages Positron Emission Tomography (PET)
EBUS-TBNA / EUS-FNA Novel approaches in lung cancer diagnostic,
staging and treatment Conclusions
3. Relevance Most common cause of cancer death Second most
common cancer in men and women 1,59 million deaths in 2012 158,040
deaths estimated in 2015 in USA More individuals die from lung
cancer than from colorectal, breast and prostate cancer
combined
4. Relevance
5. WHO classification of tumours of the lung International
Agency for Research on Cancer 4th Edition
6. Epithelial tumours Adenocarcinoma Squamous cell carcinoma
Small cell carcinoma Large cell carcinoma Adenosquamous carcinoma
Sarcomatoid carcinoma Carcinoid tumour Salivary gland tumours
Papillomas Adenomas Adenocarcinoma Squamous cell carcinoma
Neuroendocrine tumours Large cell carcinoma Adenosquamous carcinoma
Pleomprphic carcinoma Spindle cell carcinoma Giant cell carcinoma
Carcinosarcoma Pulmonary blastoma Other and unclassified carcinoma
Salivary gland-type tumours Papillomas Adenomas 2004 2015
International Agency for Research on Cancer 4th Edition
7. Adenocarcinoma Mixed subtype Acinar Papillary
Bronchioloalveolar Solid Lepidic Acinar Papillary Micropapillary
Solid Invasive Colloid Fetal Enteric Minimally invasive - MIA
Non-mucinous Mucinous Preinvasive lesions Atypical adenomatous
hyperplasia Adenocarcinoma in situ Non mucinous Mucinous 2004 2015
International Agency for Research on Cancer 4th Edition
8. TNM Detterbeck et al. CHEST 2013;
143(5)(Suppl):e191Se210S
9. Stage groups and subgroups according to TNM Detterbeck et
al. CHEST 2013; 143(5)(Suppl):e191Se210S
10. Lung carcinoma stages (I and II) Detterbeck et al. CHEST
2013; 143(5)(Suppl):e191Se210S
15. J Pathol 2014; 232: 121133 PD-1-pathway blockers
Immuno-regulatory antibodies for the treatment of cancer.
Honeychurch et al. Expert Opin Biol Ther. 2015
Jun;15(6):787-801.
16. Diagnosing and Staging Lung Cancer Involving the
Mediastinum Murgu et al. CHEST 2015; 147(5): 1401 - 1412
17. Positron Emission Tomography (PET) - Staging: T N M -
Restaging - Treatment efficacy assessment - Radiotherapy
planning
18. Positron Emission Tomography (PET) Andrea Gallamini et Al.
Cancers 2014, 6, 1821-1889 - Changes the management in 20-30% of
patients with NSCLC - T staging: accurate in up to 86% of patients
- N staging: metabolic info, but sensitivity 45% - M staging:
unsuspected distant M in 28% of patients. Impact on treatment in
53% - Limitations: low sensitivity for cerebral imaging and high
rate of false positive results (infections, sarcoidosis etc.)
19. Positron Emission Tomography (PET) Andrea Gallamini et Al.
Cancers 2014, 6, 1821-1889
32. Mehta et al. CHEST 2014; 145(3):464472 Artificial
Intelligence in Medicine 60 (2014) 165177
33. Omlor et al. Respiratory Research (2015) 16:64 Eur Respir J
2012; 40: 448454 Nanotechnology in respiratory medicine A breath
test for malignant mesothelioma using an electronic nose
34. Conclusions Tobacco prevention remains the cornerstone in
the battle against lung cancer Lung Cancer is a complex disease and
multidisciplinary approach is needed in order to obtain best
results Continuous modification and upgrading of the lung cancer
classification American Journal of Respiratory and Critical Care
Medicine, Vol. 191, No. 12 (2015), pp. 1471.
35. Conclusions Importance of international meetings and
consensuses in order to achieve maximum level of standardization
Implementation of new technologies for enhancing diagnostic,
staging and treatment of lung cancer A field of great advances, and
more exciting results to come in future years