title: The accuracy of clinical evaluative intrathoracic staging in lung cancer as assessed by postsurgical pathologic staging.
abstract: The records of 103 patients undergoing thoracotomy for carcinoma of the lung between 1985 and 1988 were reviewed. All patients underwent a uniform staging protocol in the construction of a clinical evaluative stage (cTNM). Using information obtained at thoracotomy supplemented by pathological examination a more accurate stage was constructed (pTNM). We have evaluated the accuracy of cTNM staging using the pTNM staging constructed following thoracotomy. In 46.6% patients cTN and pTN concurred. When comparing T subsets alone 81.6% patients remained unchanged. On comparing nodal staging alone 55.3% patients remained unchanged. Pre-operative evaluation underestimated far more commonly than it overestimated. Mediastinal node involvement was not overestimated since any suggestion of such involvement was confirmed by mediastinal exploration. Construction of a cTNM stage remains a crude evaluation, but we remain convinced that the major aspect of pre-operative evaluation is the exclusion of gross mediastinal gland involvement by mediastinal exploration.
authors.affiliation: Department of Thoracic Surgery, Brompton Hospital, London.
authors.forename: H C
authors.initials: HC
authors.lastname: Fernando
authors.forename: P
authors.initials: P
authors.lastname: Goldstraw
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed