|
Tumor, Node,
Metastasis International Staging
System for Lung Cancer
|
Stage |
TNM Descriptors |
5-Year Survival Rate, % |
|
Clinical Stage |
Surgical-Pathologic Stage |
|
IA
IB
IIA
IIB
IIB
IIIA
IIIB
IV |
T1 N0 M0
T2 N0 M0
T1 N1 M0
T2 N1 M0
T3 N0 M0
T3 N1 M0
T1–2–3 N2 M0
T4 N0–1–2 M0
T1–2–3–4 N3 M0
Any T any N M1 |
61
38
34
24
22
9
13
7
3
1 |
67
57
55
39
38
25
23
<5
<3
<1 |
TUMOR (T) STATUS
-
T0 No evidence of a
primary tumor
-
TX Primary tumor cannot
be assessed, or tumor proven
by the presence of malignant
cells in sputum or bronchial
washings but not visualized by
imaging or bronchoscopy
-
TIS Carcinoma in situ
-
T1 Tumor
<3
cm in greatest dimension,
surrounded by lung or visceral
pleura, without bronchoscopic
evidence of invasion more
proximal than lobar bronchus
(i.e., not in main bronchus)
-
T2 Tumor with any of
following:
>3
cm in greatest dimension;
involves main bronchus,
>2
cm distal to the carina;
invades visceral pleura;
associated with atelectasis or
obstructive pneumonitis
extending to hilum but does
not involve entire lung
-
T3 Tumor of any size
that directly invades any of
the following: chest wall
(including superior sulcus
tumors), diaphragm,
mediastinal pleura, parietal
pericardium; or tumor in main
bronchus
<2
cm distal to carina but
without involvement of carina;
or associated atelectasis or
obstructive pneumonitis of
entire lung
-
T4 Tumor of any size
that invades any of the
following: mediastinum, heart,
great vessels, trachea,
esophagus, vertebral body,
carina; or tumor with a
malignant pleural or
pericardial effusiona,
or with satellite tumor
nodule(s) within the
ipsilateral primary-tumor lobe
of the lung.
LYMPH NODE (N) INVOLVEMENT
-
NX Regional lymph nodes
cannot be assessed
-
N0 No regional lymph
node metastasis
-
N1 Metastasis to
ipsilateral peribronchial
and/or ipsilateral hilar lymph
nodes, and intrapulmonary
nodes involved by direct
extension of the primary tumor
-
N2 Metastasis to
ipsilateral mediastinal and/or
subcarinal lymph nodes(s)
-
N3 Metastasis to
contralateral mediastinal,
contralateral hilar,
ipsilateral or contralateral
scalene, or supraclavicular
lymph node(s)
DISTANT METASTASIS (M)
a
Most pleural effusions
associated with lung cancer are
due to tumor. However, in a few
patients with multiple negative
cytopathologic exams of a
non-bloody, non-exudative
pleural or pericardial effusion
that clinical judgment dictates
is not related to the tumor, the
effusion should be excluded as a
staging element and the
patient’s disease staged as T1,
T2, or T3.
b
Separate metastatic pulmonary
tumor nodule(s) in the
ipsilateral nonprimary tumor
lobe(s) of the lung are
classified as M1.
References:
-
Mountain CF. Revisions
in the International
System for Staging
Lung Cancer. Chest.
1997
Jun;111(6):1710-7.
[Medline]
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