From the Guidelines
T2N3 is classified as Stage IIIB in the TNM staging system for cancer. This staging indicates a tumor that has grown to a certain size (T2) and has spread to lymph nodes on the same side of the chest as the primary tumor, above the collarbone (N3), but has not metastasized to distant organs (M0 is implied when not specified) 1.
Key Points to Consider
- Stage IIIB represents locally advanced cancer that has significant regional lymph node involvement but remains confined to the primary region without distant spread.
- The specific implications of this staging depend on the cancer type, as different cancers use slightly modified TNM criteria.
- This staging is important for determining appropriate treatment approaches, which typically involve more aggressive interventions such as combination therapy that may include surgery, radiation, and systemic treatments.
- The prognosis for Stage IIIB varies by cancer type but generally indicates a more advanced disease that requires comprehensive treatment planning, as outlined in guidelines such as those from the Union for International Cancer Control (UICC) and the International Association for the Study of Lung Cancer (IASLC) 1.
Clinical Implications
- Accurate staging is vital to avoid erroneous interpretations leading to a false stage, resulting in undertreatment.
- For patients with abnormal mediastinal and/or hilar lymph nodes at CT and/or PET, endosonography is recommended over surgical staging 1.
- The use of the staging system for tumours with additional nodules has been left unchanged, although the approach to score same lobe nodules as T3, different ipsilateral lobe as T4 and contralateral as M1a should be restricted to the same histological (sub)type and, as such, be considered as intrapulmonary metastases 1.
From the Research
Staging of T2N3
- T2N3 is classified as stage III, specifically stage IIIB or IIIC, depending on the tumor size, lymph node involvement, and other factors 2, 3.
- The staging of T2N3 can vary depending on the specific cancer type, such as non-small-cell lung cancer (NSCLC) or gastric cancer 2, 3.
- In NSCLC, T2N3 is considered stage IIIB or IIIC, with a 5-year overall survival rate of around 8-10% 3.
- In gastric cancer, T2N3 is also considered stage III, with a 5-year overall survival rate of around 20% 2.
Prognostic Factors
- The prognosis of T2N3 patients depends on various factors, including tumor size, lymph node involvement, and the presence of metastasis 2, 3.
- Other prognostic factors include age, gender, histology, and receipt of radiotherapy 3.
- The 5-year survival rate for T2N3 patients can vary depending on these factors, with some studies reporting a significant difference in survival rates between different stages 2, 3.
Treatment Options
- Treatment options for T2N3 patients may include surgery, chemotherapy, radiation therapy, or a combination of these treatments 4, 5, 6.
- The choice of treatment depends on the specific cancer type, tumor size, lymph node involvement, and other factors 4, 5, 6.
- Some studies have reported promising results with combination therapies, such as concurrent chemotherapy and radiation therapy 5, 6.