Lung cancer TNM staging system (2009)

See also: http://staginglungcancer.org/ (by ACCP)

TNM staging 2009 : lung cancer TNM staging system 2009

T1: Tumor < 3 cm diameter, surrounded by lung or visceral pleura, without invasion more proximal than lobar bronchus.

 T1a < 2 cm
 T1b < 3 cm

T2: Tumor > 3 cm but < 7 cm, or tumor with any of the following features:
 Involves main bronchus > 2 cm distal to carina
 Invades visceral pleura
 Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung

 T2a: Primary tumor is >3 and ≤5 cm in greatest dimension.
 T2b: Primary tumor is >5 and ≤7 cm in greatest dimension

T3: Tumor > 7 cm or any of the following:

 Directly invades any of the following:

• chest wall,
• diaphragm,
• phrenic nerve,
• mediastinal pleura,
• parietal pericardium,
• main bronchus < 2 cm from carina without involvement of the carina.

 Atelectasis or obstructive pneumonitis of the entire lung
 Separate tumor nodules in the same lobe

T4: Tumor of any size that invades:

• the mediastinum,
• heart,
• great vessels,
• trachea,
• recurrent laryngeal nerve,
• esophagus,
• vertebral body,
• carina,
• separate tumor nodules in a different ipsilateral lobe.

Stage ACCP

 IA-T1aN0

• Primary tumor is ≤2 cm in greatest dimension;
• No regional lymph node metastasis;
• No distant metastasis

 IA-T1bN0

• Primary tumor is >2 but ≤3 cm in greatest dimension;
• No regional lymph node metastasis;
• No distant metastasis

 IB-T2aN0

• Primary tumor is >3 and ≤5 cm in greatest dimension;
• No regional lymph node metastasis;
• No distant metastasis

Links

 http://staginglungcancer.org/
 Canadian Cancer Society
 http://www.atcs.jp/pdf/2009_15_1/4.pdf
 Problems in Pathologic Staging of Lung Cancer.