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PROSEDUR DIAGNOSIS

Anamnesis, Pemeriksaan jasmani

Curiga Laboratorium dan histopatologi Kanker paru


Kanker Karsinoma
Paru Bukan Sel Kecil
(KPKBSK)
Foto toraks PA/Lat, CT-scan toraks s/d suprarenal, PET

CT-Brain/ MRI, Bone scan/bone survey, USG abdomen

Bronkoskop; biopsi, TBLB, BAJ, TBNA, sikatan, kureting,

bilasan, TTNA, TTB, BJH, Biopsi pleura, punksi pleura


KLINIKAL STAGING EVALUASI PRE-TERAPI

STAGE I STAGE I,
T1-2, N0 Perifer

STAGE I, MEDIASTINOKOPI* KGB


Sentral PET SCAN** MEDIASTINAL (-)

KGB
MEDIASTINAL (+)
STAGE IIA MEDIASTINOKOPI* KGB
T1-2, N1 PET SCAN** MEDIASTINAL (-)

KGB
STAGE II MEDIASTINAL (+)
T1-2, N1 OR
T3, N0-1

STAGE IIB MEDIASTINOKOPI* KGB


T3, N0-1 PET SCAN** MEDIASTINAL (-)

KGB
MEDIASTINAL (+)
STAGE IIIA
T1-2,N2

STAGE III
T1-3,N2 OR STAGE IIIA
T4, any N T3, N2
STAGE IIIB
any T, N3 or T4, any N
without efussion pleura

STAGE IIIB
T4, any N
with efussion pleura
STAGE IV
any T, any N, M1
NEOADJUVAN TERAPI INISIAL

RESEKSI

RESEKSI

LIHAT
STAGE IIIA
RESEKSI

LIHAT
STAGE IIIA

RESEKSI

LIHAT
STAGE IIIA
KEMOTERAPI CT-SCAN STABIL RESEKSI
2X TORAKS

2nd line
PROGRESIF kemoterapi

KEMOTERAPI CT-SCAN STABIL RESEKSI


2X TORAKS
2nd line
PROGRESIF kemoterapi
PI INISIAL RE-STAGING

FROZEN MARGIN SURGERY NEGATIVE (R0)

SECTION pT1-2,N0
MARGIN SURGERY POSITIVE (R1,2)

pT1-2,N1 LIHAT STAGE IIA

pT1-2,N2 LIHAT STAGE IIIA

FROZEN pT1-2,N0 MARGIN SURGERY NEGATIVE (R0)

SECTION
MARGIN SURGERY POSITIVE (R1,2)

pT1-2,N1 LIHAT STAGE IIA

pT1-2,N2 LIHAT STAGE IIIA


FROZEN pT1-2,N2 MARGIN SURGERY NEGATIVE (R0)

SECTION
MARGIN SURGERY POSITIVE (R1,2)

pT3.N2 PANCOAST TUMOR

TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH

pT1-2,N2 MARGIN SURGERY NEGATIVE (R0)

FROZEN MARGIN SURGERY POSITIVE (R1,2)

SECTION
pT3.N1-3 PANCOAST TUMOR

TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH


pT1-2,N2 PANCOAST TUMOR

TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH

pT3,N1-2 PANCOAST TUMOR

TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH

pT1-2,N2 PANCOAST TUMOR


TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH

pT3,N1-2 PANCOAST TUMOR

TUMOR SULCUS

MARGIN TUMOR PRIMER BERSIH


ADJUVAN

OBSERVASI

OBSERVASI

OBSERVASI

OBSERVASI
KEMOTERAPI + RADIOTERAPI

KEMOTERAPI + RADIOTERAPI

KONKUREN KEMOTERAPI

KEMOTERAPI + RADIOTERAPI

KEMOTERAPI + RADIOTERAPI

KONKUREN KEMOTERAPI
KONKUREN KEMOTERAPI

KONKUREN KEMOTERAPI

KONKUREN KEMOTERAPI
KONKUREN KEMOTERAPI

KEMOTERAPI 2X + KONKUREN

KEMOTERAPI OR RADIOTERAPI PALIATIF


KEMOTERAPI OR RADIOTERAPI PALIATIF