Lung cancer extensive disease

The most commonly used system of staging SCLC was developed originally by the Veterans Administration Lung Cancer Study Group. This system categorizes SCLC into two classifications limited and extensive disease.16... 

Small cell lung cancer typically presents as extensive disease (approximately 60% to 70% of new cases) and progresses very quickly. Small cell carcinomas are very responsive to chemotherapy and radiation. Radiotherapy became the standard in 1969, when a randomized trial showed that it offered the potential for cure, whereas surgery did not.20 For the vast majority of patients, chemotherapy with or without radiotherapy is the treatment of choice. Even after a complete response to therapy, the cancer usually recurs within 6 to 8 months, and survival time following recurrence is typically short ( 4 months). This yields a typical survival rate of 14 to 20 months for limited disease and 8 to 13 months for extensive disease.33 Table 87-6 illustrates the general treatment path of SCLC. 

Detection of extensive stage disease in patients with biopsy-confirmed, previously untreated, small cell lung cancer... 

A two-stage classification established by the Veterans Administration Lung Cancer Study Group is widely used in the United States to stage SCLC. Limited disease is classified as disease confined to one hemithorax and to the regional lymph nodes. All other disease is classified as extensive. Approximately 70% of patients initially present... 

Sculier JP, Paesmans M, Lecomte J, et al. A three-arm phase III randomised trial assessing, in patients with extensive-disease smallcell lung cancer, accelerated chemotherapy with support of haema-tological growth factor or oral antibiotics. Br J Cancer 2001 85 1444-1451. 

Ovarian cancer usually is confined to the abdominal cavity, but spread can occur to the lung, liver, and less commonly, bone or brain. Disease is spread by direct extension, peritoneal seeding, lymphatic dissemination, and blood-borne metastasis. 

Hypercalcemia of malignancy is a common occurrence in solid tumors of the lung and breast as well as multiple myeloma and adult T-cell lymphoma/leukemia (26). The hypercalcemia associated with breast cancer is usually seen in late stages of the disease in patients with extensive bone metastases. In squamous cell carcinoma of the lung or kidney, however, hypercalcemia is not correlated with disease stage and is not necessarily associated with bone metastases. The hypercalcemia results from increased bone resorption, decreased bone formation and increased renal tubular calcium reabsorption. These findings suggest that some tumors may secrete humoral factors with PTH-like actions. 

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