We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Sequential Staging Systems for Small-Cell Lung Cancer

Franck Chauvin, MD; Veronique Trillet-Lenoir, MD; Jean-François Cordier, MD
Arch Intern Med. 1993;153(19):2277. doi:10.1001/archinte.1993.00410190123014.
Text Size: A A A
Published online


In a recent issue of the ARCHIVES, Richardson et al1 presented the cost-saving data of the use of an algorithm for staging small-cell lung cancer.1 Among 20 160 permutations of a sequence of conventional staging procedures, they have selected the least expensive one, allowing to stop further detection of metastases as soon as an involved site has been identified. Using such a sequential method, only 60% of the 451 patients who were studied would need to undergo expensive staging procedures such as computed tomography and nucleide bone scans, as well as bone marrow aspiration and biopsy. The proposed decisional analysis allows a $1418 savings per patient, which is one third of the calculated cost of a complete staging.

Using the same type of analysis with the same decision and judgment criterion, we have previously published similar results2 in this disease. We have described a three-step staging system


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.