Accuracy of lung cancer staging in the multidisciplinary team setting

Abstract

Accurate staging of lung cancer is of utmost importance in determining the stage-appropriate treatment and prognosis. Imaging tests which include contrast-enhanced computed tomography (CT) examination of the chest to include the liver and adrenal glands and 18-fluoro-2 deoxyglucose positron emission tomography (PET)/CT scan facilitate the initial tumor node metastasis (TNM) staging of the disease and provide guidance on the optimal biopsy site and biopsy method. The diagnostic and staging approach should be tailored to the individual patient according to risk, benefit, patient preferences, and available expertise. Diagnosis and staging should preferably be accomplished with a single procedure or the least number of invasive procedures if more than one is needed. Ideally, centers managing lung cancer patients should have a multidisciplinary thoracic oncology board prescribing personalized evidence-based management tailored to each individual patient. Multidisciplinary team (MDT) meetings provide a platform for key experts from various disciplines to contribute specific advice on the management of each individual patient. As assessment of mediastinal lymph node involvement is an important component of lung cancer staging, optimal mediastinal staging can be achieved with a variety of techniques that can be discussed and performed by the various specialists in the MDT. Despite a relative paucity of quality evidence that MDT contributes to improvements in lung cancer survival outcomes, this approach has evolved to become the standard of care in many centers around the world. Thoracic MDT has resulted in more focused and timely investigations for histopathologic diagnosis and disease staging which translate into earlier treatment initiation. Moreover, there is increasing evidence that MDT care facilitates and allows access to investigations that lead to improved accuracy of tumor and nodal staging. However, there is still a paucity of evidence on the accuracy of lung cancer staging in the MDT setting.

The Impact of Multidisciplinary Team Meetings on Patient Management in Oncologic Thoracic Surgery: A Single-Center Experience

“…We have to point out some limitations of the study: as all of our patients are routinely presented and widely discussed at MDT meetings, we did not have any case-control group of patients not receiving MDT discussion, to search for an additional MDT value in terms of overall survival, disease-free survival or other clinical indicators, as reported in previous similar studies ( Table 6 ) [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”

Extreme learning machine algorithm‐based model for lung cancer classification from histopathological real‐time images

“…images is very tedious. Besides, the Accuracy of the manual lung cancer diagnostic system relies on the disease severity and the pathologist's expertise, 4 which often leads to wrong decisions. Since the morphological features of lung cancer are very complex, analyzing these scans is challenging.…”

Diagnosis of lung cancer by flexible fiberoptic bronchoscopy: a descriptive study

“…To achieve this goal, it is necessary to set up a multidisciplinary team with experts in pneumology, imaging, oncology, thoracic surgery, pathology, family medicine and patient representatives [ 10 ]. Within this team, bronchologists and pathologists play the most important roles in the positive diagnosis of LC [ 11 ].…”