TNM Classification for Non-Small Cell Lung Cancer
Primary tumor (T)
TX
Primary tumor cannot be assessed, or the tumor is proven by the presence of malignant cells in sputum or bronchial washing but is 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, no bronchoscopic evidence of invasion more proximal than the lobar bronchus (not in the main bronchus); superficial spreading of tumor in the central airways (confined to the bronchial wall )
T1a
Tumor ≤ 2 cm in the greatest dimension
T1b
Tumor > 2 cm but ≤ 3 cm in the greatest dimension
T2
Tumor > 3 cm but ≤ 7 cm or tumor with any of the following:
-
Invades visceral pleura
-
Involves the main bronchus ≥ 2 cm distal to the carina
-
Associated with atelectasis/obstructive pneumonitis extending to hilar region but not involving the entire lung
T2a
Tumor > 3 cm but ≤ 5 cm in the greatest dimension
T2b
Tumor > 5 cm but ≤ 7 cm in the greatest dimension
T3
Tumor > 7 cm or one that directly invades any of the following:
-
Chest wall (including superior sulcus tumors), diaphragm, phrenic nerve, mediastinal pleura, or parietal pericardium;
Or tumor in the main bronchus < 2 cm distal to the carina but without involvement of the carina
Or associated atelectasis/obstructive pneumonitis of the entire lung or separate tumor nodule(s) in the same lobe
T4
Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina; or separate tumor nodule(s) in a different ipsilateral lobe
Regional lymph nodes (N)
NX
Regional lymph nodes cannot be assessed
N0
No regional node metastasis
N1
Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension
N2
Metastasis in the ipsilateral mediastinal and/or subcarinal lymph node(s)
N3
Metastasis in the contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes
Distant metastasis (M)
MX
Distant metastasis cannot be assessed
M0
No distant metastasis
M1
Distant metastasis
M1a
Separate tumor nodule(s) in a contralateral lobe; tumor with pleural nodules or malignant pleural (or pericardial) effusion
M1b
Distant metastasis
.
