T; primary tumour
TX; primary tumour cannot be assessed or cytologically proven but not visualised
T0; no evidence of primary tumour
Tis; carcinoma in situ
T1; tumour < 3cm diameter and not in main bronchus. Includes superficial spreading tumour of any size limited to the bronchial wall, even if spreading into the main bronchus. It has been proposed that tumours <3cm and with involvement of the elastic lamina of the visceral pleura be upgraded to T22.
T2; tumour more than 3 cm diameter or (involves main bronchus and more than 2 cm from carina) or invades visceral pleura1,2 associated with atelectasis/obstructive pneumonitis extending to hilum but not the entire lung. It has been proposed that tumours >3cm and with involvement of the elastic lamina of the visceral pleura be upgraded to T32.
T3; invades any of chest wall, diaphragm, mediastinal pleura, parietal pericardium or present in main bronchus less than 2 cm from carcinoma but not involving carina or associated with atelectasis/obstructive pneumonitis of the entire lung.
T4; invades any of mediastinum, heart, great vessels, carina, trachea, oesophagus, vertebral body or separate nodule in the same lobe or malignant pleural effusion.
N; regional lymph node
NX; regional lymph nodes cannot be assessed
N0; no nodal metastases
N1; ipsilateral intrapulmonary, peribronchial or hilar nodal metastases or direct spread.
N2; metastases in ipsilateral mediastinal or subcarinal nodes
N3; metastases in contralateral mediastinal or hilar or in any scalene or supraclavicular nodes.
M; distant metastasis
MX; distant metastases cannot be assessed
M0; no distant metastases
M1; distant metastases or separate nodule in a different lobe
Stage grouping
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For further information on TNM staging, see www.uicc.org/faq
Reference
0Tumours of the Lung, Pleura, Thymus and Heart. WHO Classification of Tumours. IARC Press 2004.