2023 NCCN V1围手术期诊断评估和治疗更新全文.docx
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1、2023NCCNV1围手术期诊断、评估和治疗更新(全文)近日,非小细胞肺癌(NSC1C)NCCNV1版更新,此版更新(对比2023V6版)针对早期和局部晚期NSC1C的诊断、治疗等领域进行了大篇幅的更新。详情如下:DIAG-A1/3诊断评估原则NCCNNationa1ComprehensiveCancerNetwork*NCCNGuide1inesVersion1.2023Non-Sma11Ce111ungCancerNCCNGmctofcneBIndexTab1eofContentsDiscussionPRINCIP1ESOFDIAGNOSTICEVA1UATIONPatientswitha
2、strongc1inica1suspicion0mU90IAungcancer(basedonriskfactorsandradkkgicappearance)donotrequireabiopsybeforesurgery.Abiopsyaddstime,costs,andprocedura1riskandmaynotbneededfortreatmentdecisions.,ApreoperativbiopsymaybeappropriateHanonJungcancerdiagnosisisstrong1ysuspctedthatcanbediagnosedbycorebiopsyorf
3、iGd1aspiration(FNA1ttvbkpsymaybeusfu1forpatintsvvtthc1inica1stgIBorhigherwhomaybcandidatesforsystemictherapypriortoAprooperativobiopsymayboappropriaterfanIntraoperativodiagnosisappearsdifficu1torveryrisky?IfapreopratrvtissudiagnosishasnotboonobUind.thnanitrxprativdiagnosis(i.wdgrsction.nd1biopy)isne
4、cessary*preoperativebronchoscopymayaobepreferredfortiuedia90sand/ormediata1staging(endobronca1uttraound(EBUS).ITabronchoscopyhasnotbeenprevious1ypertornedtordiagnosisorstaging,bronchoscopyshou1dbeperformedduringthep1annedsurgica1resection,ratherthanasaseparateprocedure.Bronchoscopyisrequiredbeforesu
5、rgica1resection(NSCV2). AsparatbronchoscopymaynotbnMddfortreatmentdecisionsbforttimofsurgeryandaddstime,costs,andprocedura1risk. ApreoperativebronchoscopymaybeappropriateIfacentra1tumorrequirespre-reMctioneva1uationforbiopsy,surgica1p1anning(g.potentia1sgerMCtio),orproprativoairwaypropartion(g.corin
6、goutanobstructive1sion). Invasivomediastina1stagingisrecommendedbeforesurgica1resectionformostpatientswithc1inica1stageIorH1ungcancer(NSC12).FOfpatientsundergoingEBUSndoscopicu1trasound(EUS)staging,thismostcommon1yshou1dbasoparatproceduretoa11owpatho1ogicva1uation. Patientshavingmediastinoscopyshou1
7、dpreferab1yUndergOInvasivemediastina1staging(mediastinoscopy)astheinitia1stpbeforethep1annedresection(duringthesameanestheticprocedure),ratherthanasaseparateprocedure. aahpro6durdosiig.cost,drAAthotcr.idovo6d6.artandoaanestnttcr1iik. PreopQrativoinvasivemediastina1stagingmaybeappropriateforastrongCM
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