NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 32

NCCN Guidelines for Patients
: Non-Small Cell Lung Cancer
Version 1.2014
Part 4: Lung cancer staging
N = Nodes
Cancer cells can spread throughout the body by traveling
in lymph as explained in Part 1. Lymph in the lung tissue
first travels to the intrapulmonary and peribronchial lymph
nodes inside the lungs. From these nodes, lymph then
travels to the hilar nodes. Hilar lymph nodes are found
right outside the lungs where the bronchi attach.
From the hilar nodes, lymph travels to lymph nodes in the
mediastinum. The mediastinum is the center of the chest
where the heart is located. Subcarinal nodes are located
right below the windpipe. Lymph also travels above
the collarbone to the supraclavicular nodes and to the
scalene nodes within the neck.
Nearby lymph nodes are shown in Figure 5. The N
category reflects how far lung cancer has spread within
these lymph nodes. N scores for lung cancer include:
means that there is no cancer in nearby
lymph nodes.
means that the cancer has spread to the
peribronchial nodes and/or to the hilar and
intrapulmonary nodes of the lung with the
primary tumor.
means that the cancer has spread to mediastinal
nodes, which include subcarinal nodes, near the
lung with the primary tumor.
means that the cancer has spread to the
mediastinal or hilar nodes near the lung without the
primary tumor, or to any supraclavicular or scalene
lymph nodes.
Figure 5. Nearby lymph nodes
Illustration Copyright © 2013 Nucleus Medical Media, All rights
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