《2010ESMO臨床實踐指南：小細胞肺癌》內(nèi)容預覽

incidence

The most common cause of cancer-related deaths in Europe in2006 is lung cancer (estimated 334 800 deaths). After prostatecancer, lung cancer is the most frequent type of cancer in men.

Age-standardized incidence and mortality rates in 2006 areestimated to be 75.3 and 64.8/100 000/year, respectively, inmen, and 18.3 and 15.1/100 000/year in women. Small-cell lungcancer (SCLC) accounts for 15%–18% of all cases. In recentyears the incidence of SCLC has decreased. SCLC is stronglyassociated with tobacco smoking.

diagnosis

Pathological diagnosis should be made according to the WHOclassification. Biopsies can be obtained by flexiblebronchoscopy, mediastinoscopy, endoscopic ultrasound,transthoracic needle aspiration and thoracoscopy depending onthe localization of the tumour. A biopsy from a metastaticlesion can substitute for a biopsy from the primary tumour.The least invasive approach should be used [V, D].

staging and risk assessmentStaging procedures should include medical history, physicalexamination, chest X-ray, complete blood count includingdifferential count, liver, lung and renal function tests, lactatedehydrogenase (LDH) and sodium levels, and a CT scan of thechest and abdomen including the liver and adrenal glands.In patients with symptoms or abnormal physical

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