Teaching Points
- It is important to accurately stage NSCLC, as stages I to IIIA are potentially resectable and curable.
- Chest X-Ray is indicated in all patients but has low sensitivity for detecting lesion spread.
- A CT of the chest and upper abdomen is indicated in all patients, as it allows for the evaluation of the size and extent of the primary tumour and metastatic spread to the mediastinum/upper abdomen.
- A PET scan is indicated in all patients with NSCLC who DO NOT have evidence of greater than stage IIIB disease (non-curative) disease on CT scans.
- Increasingly, NSCLC is staged with combined PET-CT.
- Tissue confirmation is an important investigation prior to consideration of curative surgery. Tissue may be obtained via mediastinoscopy, endoscopy, endobronchoscopy or percutaneous FNA.
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