Primary tumor (T) |
TX | Primary tumor cannot be assessed |
T0 | No evidence of primary tumor |
T1 | Tumor limited to the ipsilateral parietal pleura with or without mediastinal pleura and with or without diaphragmatic pleural involvement |
T1a | No involvement of the visceral pleura |
T1b | Tumor also involving the visceral pleura |
T2 | Tumor involving each of the ipsilateral pleural surface (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following: |
Involvement of diaphragmatic muscle |
Extension of tumor from visceral pleura into the underlying pulmonary parenchyma |
T3 | Locally advanced but potentially resectable tumor |
Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following: |
Involvement of the endothoracic fascia |
Extension into the mediastinal fat |
Solitary, completely resectable focus of tumor extending into the soft tissues of the chest wall |
Nontransmural involvement of the pericardium |
T4 | Locally advanced technically unresectable tumor |
Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following: |
Diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction |
Direct transdiaphragmatic extension of tumor to the peritoneum |
Direct extension of tumor to the contralateral pleura |
Direct extension of tumor to mediastinal organs |
Direct extension of tumor into the spine |
Tumor extending through to the internal surface of the pericardium with or without a pericardial effusion or tumor involving the myocardium |
Regional lymph nodes (N) |
NX | Regional lymph nodes cannot be assessed |
N0 | No regional lymph node metastases |
N1 | Metastases in the ipsilateral bronchopulmonary or hilar lymph nodes |
N2 | Metastases in the subcarinal or the ipsilateral mediastinal lymph nodes including the ipsilateral internal mammary and peridiaphragmatic nodes |
N3 | Metastases in the contralateral mediastinal, contralateral internal mammary, ipsilateral or contralateral supraclavicular lymph nodes |
Distant metastasis (M) |
M0 | No distant metastasis |
MI | Distant metastasis present |
Anatomic stage/prognostic groups |
Stage I | T1 | N0 | M0 |
Stage IA | T1a | N0 | M0 |
Stage IB | T1b | N0 | M0 |
Stage II | T2 | N0 | M0 |
Stage III | T1, T2 | N1 | M0 |
T1, T2 | N2 | M0 |
T3 | N0, N1, N2 | M0 |
Stage IV | T4 | Any N | M0 |
Any T | N3 | M0 |
Any T | Any N | M1 |