Primary Tumor (T)

TX: Primary tumor cannot be assessed, or tumor is proven by the presence of malignant cells in sputum or bronchial washings but is not visualized by imaging or bronchoscopy

T0: No evidence of primary tumor

T1: A tumor that is 3 cm or smaller in greatest dimension, is surrounded by lung or visceral pleura, and is without bronchoscopic evidence of invasion more proximal than the lobar bronchus (i.e., not in the main bronchus).

T2: A tumor with any of the following features of size or extent:

• Larger than 3 cm in greatest dimension
• Involves the main bronchus and is 2 cm or larger distal to the carina
• Invades the visceral pleura
• Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung

T3: A 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 the main bronchus less than 2 cm distal to the carina but without involvement of the carina; or, associated atelectasis or obstructive pneumonitis of the entire lung

T4: A tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or, separate tumor nodules in the same lobe; or, tumor with a malignant pleural effusion.

 

Regional Lymph Nodes (N)

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 including involvement by direct extension of the primary tumor

N2: Metastasis to ipsilateral mediastinal and/or subcarinal lymph node

N3: Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node

 

Distant Metastasis (M)

MX: Distant metastasis cannot be assessed

M0: No distant metastasis

M1: Distant metastasis present. Note: M1 includes separate tumor nodule(s) in a different lobe (ipsilateral or contralateral).

 

Once the tumor, lymph nodes and metastases are determined, the cancer is given a stage, depending on the number of tumors, lymph nodes and metastases, as seen here.

 

Occult Carcinoma

TX, N0, M0

Stage 0

Tis, N0, M0

Stage IA

T1, N0, M0

Stage IB

T2, N0, M0

Stage IIA

T1, N1, M0

Stage IIB

T2, N1, M0

T3, N0, M0

Stage IIIA

T1, N2, M0

T2, N2, M0

T3, N1, M0

T3, N2, M0

Stage IIIB

Any T, N3, M0

T4, any N, M0

Stage IV

Any T, any N, M1