title: Comparison of clinical and pathological tumor, node and metastasis staging of lung cancer: 15-year experience with 530 patients.
abstract: OBJECTIVE
  The prognosis of patients with lung cancer depends on early diagnosis and accurate staging. The present staging system for lung cancer is tumor (T), node (N), and metastasis (M) staging (TNM). We compared the accuracy of preoperative (clinical) and postoperative (pathological) TNM staging of lung cancer in this study and emphasized the preoperative mediastinoscopy is useful in selected patients.
  
  
  METHODS
  We performed a retrospective comparison of the clinical and pathological TNM staging of 530 patients with lung cancer treated surgically. The preoperative clinical TNM staging of all patients was based on physical examination, radiological investigations and bronchoscopy. Mediastinoscopy was used routinely for all patients with an indication since 2000.
  
  
  RESULTS
  We found the agreement between clinical and pathological TNM staging to be only 46.4%. The comparison between clinical and pathological TNM staging was 6.2-5.3% at stage Ia, 37.9%-36% at stage Ib, 0.7-0.9% at stage IIa, 23-25% at stage IIb, 27.1-16.2% at stage IIIa, and 3.2-14% at stage IIIb respectively. The frequency rates of the different clinical and pathologic stages were 6.2% and 5.3%, for stage Ia, 37.9% and 36% for stage Ib, 0.7% and 0.9% for stage IIa, 23% and 25% for stage IIb, 27.1% and 16.2% for stage IIIa, 3.2% and 14% for stage IIIb respectively.
  
  
  CONCLUSIONS
  We compared the clinical and pathological staging in patients with non small cell lung cancer submitted to surgical treatment to identify the causes of any discordance. The clinical TNM and staging based on computerized tomography was found to be inaccurate.
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren State Hospital, Izmir, Turkey. figenturk@pau.edu.tr
authors.forename: F
authors.initials: F
authors.lastname: Turk
authors.forename: S
authors.initials: S
authors.lastname: Gursoy
authors.forename: S
authors.initials: S
authors.lastname: Yaldiz
authors.forename: G
authors.initials: G
authors.lastname: Yuncu
authors.forename: S
authors.initials: S
authors.lastname: Yazgan
authors.forename: O
authors.initials: O
authors.lastname: Basok
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome