Principles of cancer staging

Abstract

Staging is the process to group patients with more or less similar disease, prognosis, and possible response to a certain therapy. It allows us to compare different therapies within similar groups. Clinical staging consists of physical examination, radiological evaluation, laboratory testing, and recently the use of minimallyinvasive techniquesPET/CT scanning has now obtained a firm place in this process and is considered to be cost-effective. A more recent development is the use of the minimally invasive techniques like endobronchial ultrasound(EBUS) and endo-esophageal ultrasound (EUS). They contribute significantly to the staging process and improve the selection of patients for studies or local treatments like chemoradiotherapy. In addition, the indication for surgical techniques (thoracoscopy and mediastinoscopy) is also reviewed. The use of the seventh international staging system and the impact of the new techniques are discussed in this chapter.