NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 58

NCCN Guidelines for Patients
: Non-Small Cell Lung Cancer
Version 1.2014
Part 7: Treatment by cancer stage
This chart maps surgical treatment for both stage IIA and
IIB lung cancer without invasion. These stage IIB tumors
have not grown into surrounding structures, such as the
chest wall. There may be secondary tumors in the same
lobe as the primary tumor.
7.2 Stage II treatments
You may have stage II lung cancer based on tests given
before treatment. Or you may have been upstaged to
stage II cancer after surgery. A stage IIA tumor is 3 cm
or smaller with cancer in the lung’s lymph nodes. Larger
stage IIA tumors are between 5.1 and 7 cm but the cancer
hasn’t spread to any nodes. Stage IIA tumors have not
invaded nearby tissue.
A stage IIB tumor can also be as large as 7 cm but the
lung’s nodes have cancer. Stage IIB tumors also include
those larger than 7 cm without cancer in the lymph nodes,
those that have invaded the chest wall or bronchi, or those
with secondary tumors in the same lobe.
Stage IIA and IIB without invasion
Surgical options
Stage IIA
T1, N1
T2a, N1
Stage IIA
T2b, N0
No cancer in margins
Observation, or
Chemotherapy if high risk
Adjuvant treatment
Stage and margin status
Lung tumor
and lymph
node surgery
Stage IIB
T2b, N1
T3, N0
Primary treatment
Cancer not seen
with naked eye
Cancer seen
with naked eye
No cancer in margins
Cancer in margins
Surgery + chemotherapy, or
Concurrent or sequential chemoradiation
Surgery + chemotherapy, or
Concurrent chemoradiation
Surgery (preferred) ± chemotherapy, or
Radiation therapy ± chemotherapy
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