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Lung cancer TNM staging system (2009)

Tuesday 25 September 2012

Lung carcinoma staging system

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.