1992 TNM Classification and Staging of Lung Carcinoma

Description

The TNM staging system is used by the American Joint Commission on Cancer (AJCC) and the Union Internationale Contre le Cancer (UICC).

Parameter	Code	Definition
primary tumor	TX	primary tumor cannot be assessed
	TX	tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy
	T0	no evidence of primary tumor
	Tis	carcinoma in situ
	T1	tumor <= 3 cm in diameter, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (not involving main bronchus)
	T1	superficial tumor of any size with its invasive component limited to the bronchial wall, which may extend proximal to the main bronchus
	T2	more than 3 cm in diameter
	T2	involving the main bronchus, 2 cm or more distal to the carina
	T2	invading the visceral pleura
	T2	atelectasis or obstructive pneumonitis extending to the hilar region but not involving the entire lung
	T3	tumor of any size that directly invades the chest wall (including superior sulcus tumor), diaphragm, mediastinal pleura, parietal pericardium
	T3	tumor in the main bronchus less than 2 cm distal to the carina but without direct involvement of the carina
	T3	atelectasis or obstructive pneumonitis of the entire lung
	T4	tumor of any size invading the mediastinum, heart, great vessels, trachea, esophagus, vertebral body, or carina
	T4	tumor with a malignant pleural effusion
regional lymph nodes	NX	regional lymph nodes cannot be assessed
	N0	no regional lymph node metastasis
	N1	metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, including direct extension
	N2	metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes
	N3	metastasis in contralateral mediastinal, hilar, scalene or supraclavicular lymph nodes
	N3	metastasis to ipsilateral scalene or supraclavicular lymph nodes
distant metastasis	MX	presence of distant metastasis cannot be assessed
	M0	no distant metastasis
	M1	distant metastasis (often liver, brain, bone, adrenal gland, kidney, and contralateral lung)
	M1	metastasis to nonregional lymph nodes, including jugular lymph nodes

Regional lymph nodes

Intrapulmonic:

(1) hilar (proximal lobar)

(2) peribronchial

(3) intrapulmonic

Mediastinal:

(1) peritracheal and tracheobronchial

(2) pretracheal and retrotracheal, including precarinal

(3) aortic (includes subaortic, aorticopulmonary window, and periarotic)

(4) carinal

(5) periesophageal

(6) pulmonary ligament

(7) anterior mediastinal

(8) posterior mediastinal

Stages

Stage	T	N	M
occult	TX	N0	M0
Stage 0	Tis	N0	M0
Stage I	T1	N0	M0
	T2	N0	M0
Stage II	T1	N1	M0
	T2	N1	M0
Stage IIIA	T1	N2	M0
	T2	N2	M0
	T3	N0	M0
	T3	N1	M0
	T3	N2	M0
Stage IIIB	any T	N3	M0
	T4	any N	M0
Stage IV	any T	any N	M1

To read more or access our algorithms and calculators, please log in or register.

1992 TNM Classification and Staging of Lung Carcinoma

Description

Specialty