T: Primary tumor |
Tx | Primary tumor cannot be assessed or tumor proven by 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 greatest dimension surrounded by lung or visceral pleura without bronchoscopic evidence of invasion more proximal than the lobar bronchus (ie, not in the main bronchus)* |
T1a(mi) | Minimally invasive adenocarcinoma¶ |
T1a | Tumor ≤1 cm in greatest dimension* |
T1b | Tumor >1 cm but ≤2 cm in greatest dimension* |
T1c | Tumor >2 cm but ≤3 cm in greatest dimension* |
T2 | Tumor >3 cm but ≤5 cm or tumor with any of the following features:Δ - Involves main bronchus regardless of distance from the carina but without involvement of the carina
- Invades visceral pleura
- Associated with atelectasis or obstructive pneumonitis that extends to the hilar region, involving part or all of the lung
|
T2a | Tumor >3 cm but ≤4 cm in greatest dimension |
T2b | Tumor >4 cm but ≤5 cm in greatest dimension |
T3 | Tumor >5 cm but ≤7 cm in greatest dimension or associated with separate tumor nodule(s) in the same lobe as the primary tumor or directly invades any of the following structures: chest wall (including the parietal pleura and superior sulcus tumors), phrenic nerve, parietal pericardium |
T4 | Tumor >7 cm in greatest dimension or associated with separate tumor nodule(s) in a different ipsilateral lobe than that of the primary tumor or invades any of the following structures: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, and carina |
N: Regional lymph node involvement |
Nx | Regional lymph nodes cannot be assessed |
N0 | No regional lymph node metastasis |
N1 | Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension |
N2 | Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s) |
N3 | Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s) |
M: Distant metastasis |
M0 | No distant metastasis |
M1 | Distant metastasis present |
M1a | Separate tumor nodule(s) in a contralateral lobe; tumor with pleural or pericardial nodule(s) or malignant pleural or pericardial effusion◊ |
M1b | Single extrathoracic metastasis§ |
M1c | Multiple extrathoracic metastases in one or more organs |
Stage groupings |
Occult carcinoma | TX | N0 | M0 |
Stage 0 | Tis | N0 | M0 |
Stage IA1 | T1a(mi) | N0 | M0 |
T1a | N0 | M0 |
Stage IA2 | T1b | N0 | M0 |
Stage IA3 | T1c | N0 | M0 |
Stage IB | T2a | N0 | M0 |
Stage IIA | T2b | N0 | M0 |
Stage IIB | T1a to c | N1 | M0 |
T2a | N1 | M0 |
T2b | N1 | M0 |
T3 | N0 | M0 |
Stage IIIA | T1a to c | N2 | M0 |
T2a to b | N2 | M0 |
T3 | N1 | M0 |
T4 | N0 | M0 |
T4 | N1 | M0 |
Stage IIIB | T1a to c | N3 | M0 |
T2a to b | N3 | M0 |
T3 | N2 | M0 |
T4 | N2 | M0 |
Stage IIIC | T3 | N3 | M0 |
T4 | N3 | M0 |
Stage IVA | Any T | Any N | M1a |
Any T | Any N | M1b |
Stage IVB | Any T | Any N | M1c |