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Clinical calculator summary

Classic VALG SCLC Stage

The original two-stage limited versus extensive classification for small-cell lung cancer.

Evidence-based context for fast calculator use

Purpose:
Reproduce the classic VALG anatomical and historical radiation-field classification.
Population:
Patients with confirmed SCLC undergoing adequate initial pretreatment staging.
Factors:
Hemithorax extent, Original VALG nodal boundary, Pleural/pericardial effusion, Extrathoracic metastasis, Historical radiation-field feasibility
Reference:
Zelen M. Cancer Chemother Rep. 1973;4:31-42.
HomeSmall Cell Lung Cancer Staging (VALSG)
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Small Cell Lung Cancer Staging (VALSG)

Clinical Context & Background

This calculator implements the classic 1973 Veterans Administration Lung Study Group two-stage system for confirmed small-cell lung cancer at initial pretreatment staging. Limited stage requires disease confined to one hemithorax, nodal extent within the original VALG boundary, no confirmed malignant pleural or pericardial effusion, no extrathoracic metastasis, and disease that can be adequately encompassed in one radiation field.
The historical limited-stage nodal boundary may include ipsilateral supraclavicular nodes only when they can be encompassed with the primary tumor; contralateral mediastinal, hilar, or supraclavicular nodes are extensive in this selected version. This calculator does not silently apply the broader 1989 IASLC modification and does not replace contemporary TNM staging. Radiation-field feasibility requires specialist assessment. Do not calculate when effusion status remains indeterminate.
Primary Source EvidenceZelen M. Cancer Chemother Rep. 1973;4:31-42. Stahel RA, et al. Lung Cancer. 1989;5:119-126. Micke P, et al. Lung Cancer. 2002;37:271-276.
Formula Logic
Classic 1973 VALG limited stage requires disease confined to one hemithorax, nodal extent within the original VALG limit, no confirmed malignant pleural or pericardial effusion, no extrathoracic metastasis, and disease adequately encompassable in one radiation field. Otherwise the disease is extensive stage.

Reference Data

StageClassic 1973 VALG definition
LimitedOne hemithorax; nodes within original VALG boundary; no malignant pleural/pericardial effusion; no extrathoracic metastasis; adequately encompassable in one radiation field
ExtensiveAny limited-stage condition is not met, including contralateral nodal or pulmonary disease, malignant pleural/pericardial effusion, extrathoracic metastasis, or inability to encompass disease adequately

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • After confirming SCLC and completing initial pretreatment clinical and radiological staging.
  • Use only when every classic VALG criterion, including effusion status and radiation-field feasibility, has been assessed.

How To Interpret

  • Limited means all five original conditions are met.
  • Extensive means at least one original limited-stage condition is not met.

What To Do Next

  • Document the anatomical findings that support the classification.
  • Record contemporary TNM stage separately and integrate staging into multidisciplinary assessment.

Limitations

  • Not for NSCLC, unconfirmed pathology, recurrent-only disease, or post-treatment restaging.
  • Indeterminate pleural or pericardial effusion prevents classification.
  • The historical one-field concept is not a standalone treatment recommendation.
  • The 1989 IASLC modification and contemporary TNM are outside this calculator.

Validated Population

Confirmed SCLC at initial pretreatment staging in the historical VALG source context.

Contralateral mediastinal nodes

Under the classic VALG definition selected here, contralateral mediastinal nodal disease is extensive stage even if no distant metastasis is present.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Five source-backed classic VALG cases were exercised on the public production route through visible controls; 5/5 expected Limited or Extensive classifications matched.
    • The formerly visible literal undefined trace values were absent, and no unexpected N/A, stale control, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/small-cell-lung-cancer-staging-2026-08-03.json.

  2. : Local browser remediation verification

    • Ten source-backed cases passed through visible local browser controls across 11 submissions after the shared result-trace correction.
    • The run covered Limited stage, every individual Extensive-stage trigger, multiple concurrent triggers, indeterminate effusion, missing required input, and reset/repeat behavior.
    • All five visible criteria rows displayed defined narrative values with no literal undefined or NaN. The original production findings remain open until deployment and public revalidation.

    Case-level local remediation evidence is retained in validation/browser-production/small-cell-lung-cancer-staging.local-remediation.json.

  3. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 2/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-ui-and-console. high: Every valid Limited or Extensive result displayed literal `undefined` values in the visible staging-criteria trace. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/small-cell-lung-cancer-staging.json.

  4. : Full validation test

    • 192/192 source-scenario, independent-oracle, UI, strict-input, trace, version, scope, registry, report, and isolation checks passed.
    • This verifies implementation of the selected historical classification, not independent clinical validation, current TNM staging, prognosis, or treatment selection.

  5. : Calculation and input-contract correction

    • Replaced the one-question approximation with all five classic VALG limited-stage conditions and explicit extensive-stage branches.
    • Removed the favorable default, coercion, anatomical omissions, and treatment-prescriptive output; indeterminate effusion now returns Invalid Input.
    • Separated the classic 1973 VALG system from the broader 1989 IASLC modification and contemporary TNM staging.

    Included in the current validation report.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

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Frequently Asked Questions

Is this the broader IASLC limited-stage definition?

No. This page implements the classic 1973 VALG system. The broader 1989 IASLC modification is a separate definition and is not silently applied.

Does this replace TNM staging?

No. Contemporary TNM staging should be recorded separately; this historical two-stage system remains a distinct classification.

What does one radiation field mean?

It is a historical staging concept referring to whether the primary tumor and permitted regional disease could be encompassed adequately in one radiation field. Specialist assessment is required.

Evidence-based oncology decision support. Verify with clinical guidelines.