title: Detection of occult metastases in lung carcinomas: progress and implications for lung cancer staging.
abstract: The ability to detect occult regional and systemic metastases in patients with operable lung carcinoma could have a significant impact on the management of the disease. Here, we review the literature, including studies from our own laboratory, regarding the clinical significance of the presence of occult metastases in patients with lung cancer. The accumulated evidence strongly suggests that the detection of occult regional and systemic metastases is an important predictor of disease progression. The use of this method should be considered in the future design of lung cancer clinical trials, at the very least. The detection of occult metastases should have an impact on lung cancer management; to reflect this, we propose a change in the TNM staging system to indicate the presence or absence of occult regional (lymph node) and systemic (bone marrow) metastases. The proposed change is TNnMm, where n and m are occult nodal and bone marrow metastases status.
authors.affiliation: Department of Pathology, University of Southern California School of Medicine, Los Angeles 90033, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Cote
authors.forename: D
authors.initials: D
authors.lastname: Hawes
authors.forename: B
authors.initials: B
authors.lastname: Chaiwun
authors.forename: E J
authors.initials: EJ
authors.lastname: Beattie
mesh_terms: D019046:Bone Marrow Neoplasms / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary*; D004273:DNA, Neoplasm / Q000032:analysis; D018572:Disease-Free Survival; D005434:Flow Cytometry; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D004273:DNA, Neoplasm