Jamal. CA Cancer J Clin 2011. Lewis. SEER Cancer Statistics Review, 1975-2008. 2010.

Goldstraw. J Thorac Oncol 2007.

Detterbeck. Chest 2013.

Mass

N1 N2

N2

N3

N3

Detterbeck. Chest 2013.

Detterbeck. Chest 2009.

Overall Stage Treatment Median 5 year Survival

Stage I Surgical resection or localized radiation for curative

intent

61%

Stage II Surgical resection or localized radiation, followed by systemic

therapy for curative intent

38%

Stage III Systemic therapy and radiation, possibly followed by surgery for

curative intent

23%

Stage IV Systemic therapy or hospice 4%

Lewis. SEER Cancer Statistics Review, 1975-2008. 2010. Goldstraw. J Thorac Oncol 2007.

Silvestri. Chest 2013.

Fischer. NEJM 2009.

Detterbeck. Chest 2009.

Silvestri. Chest 2013.

Detterbeck. Chest 2009.

Herth. Eur Respir J 2006. Herth. Chest 2008.

Saettele. Respirology 2014.

Yasafuku. Chest 2006.

Yasafuku. Lung Cancer 2005.

Almeida. Chest 2013.

Swensen. Arch Intern Med 1997.

http://www.chestx-ray.com/index.php/calculators/spn-calculator

Swensen. Arch Intern Med 1997.

0 0.2 0.4 0.6 0.8 1

Observation with serial CT Further Testing Surgical Resection

Observation–Test Threshold

Test-Treat Threshold

Patient desires certainty

Patient averse to surgery High risk of surgery

Probability of Lung Cancer Ost. Am J Respir Crit Care Med 2012.

Silvestri. Chest 2013. Ost. Am J Respir Crit Care Med 2012.

0 0.2 0.4 0.6 0.8 1

Observation with serial CT Further Testing Surgical Resection

Observation–Test Threshold

Test-Treat Threshold

Probability of Lung Cancer

Positive PET-CT

0 0.2 0.4 0.6 0.8 1

Observation with serial CT Further Testing Surgical Resection

Observation–Test Threshold

Test-Treat Threshold

Probability of Lung Cancer

Negative PET-CT

Consider Biopsy

Saettele. Respirology 2014.