Staging of Malignant Disease PDF
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King Khalid University
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Summary
This document discusses the staging of malignant diseases, emphasizing the importance of accurate staging for appropriate patient management. It highlights the role of imaging techniques like bone scans and PET scans in determining the extent of disease. The text also addresses the potential risks of overstaging or understaging.
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Staging of Malignant Disease ▪ Staging of cancer depends on the size of the primary neoplasm, its extent to regional lymph nodes, and the presence or absence of metastasis. ▪ Accurate staging of malignant lesions at the time of initial presentation is of utmost importance to provide appropriate mana...
Staging of Malignant Disease ▪ Staging of cancer depends on the size of the primary neoplasm, its extent to regional lymph nodes, and the presence or absence of metastasis. ▪ Accurate staging of malignant lesions at the time of initial presentation is of utmost importance to provide appropriate management for a particular patient. 12 Staging of Malignant Disease ▪ Overstaging can inappropriately deprive a patient from receiving curative treatment such as surgery. ▪ On the other hand understaging can subject a patient to undergo futile but drastic treatments that can even increase the morbidity and mortality (e.g. pneumonectomy in lung cancer) without any increase in the chance of cure. ▪ Imaging plays a significant role in staging. Bone imaging using 99mTc MDP and 18F has established value in detecting metastatic bone disease. ▪ Similarly, several radiopharmaceuticals are used in staging and follow-up of neuroendocrine tumors. 13 Staging of Malignant Disease ▪ Although the ideal staging is a microscopic process, many times it is not possible to biopsy each and every lesion to find out whether they are malignant or not. ▪ Nuclear medicine procedures, especially 18F FDG-PET, have a higher degree of accuracy compared with CT or MRI alone in staging tumors particularly lymph node involvement. ▪ The accuracy of CT in staging mediastinal disease in lung cancer as an example is approximately 70 %; MRI is slightly higher at around 80 %, while 18F FDG accuracy is better than 90 %. 14