Case studies in the diagnosis and staging of non-small cell lung cancer

Lung cancer is the most common cause of cancer death in men and women. Whil e overall survival rates remain dismal, survival for early stage disease ap proaches 70%. Expedient, accurate staging is vital to ensure timely resecti on of all potentially curable disease. Conversely, accurate staging is impo rtant in preventing unnecessary surgery, While a negative clinical evaluati on has a high negative predictive value, many clinicians routinely order co nventional imaging to exclude distant metastases, In this article, five cas e vignettes are presented to demonstrate the international system for stagi ng lung cancer, including the most recent modifications. Various tumor char acteristics and patterns of lymph node involvement are explored to demonstr ate the subtleties of staging. The accuracy of various diagnostic modalitie s in the evaluation for mediastinal and distant metastasis is discussed.