Table 35.5. TNM classification of lung cancer
| Table 35.5. TNM classification of lung cancer. |
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Primary tumor (T): TX Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy T0 No evidence of primary tumor Tis Carcinoma in situ T1 Tumor 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (i.e., not in the main bronchus) T2 Tumor with any of the following features of size or extent: more than 3 cm in greatest dimension, involves main bronchus, 2 cm or more distal to the carina; invades the visceral pleura; associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does involve the entire lung T3 Tumor of any size that directly invades any of the following: chest wall (includes superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium, tumor in the main bronchus less than 2 cm distal to the carina but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung T4 Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or tumor with a malignant pleural effusion |
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Regional lymph nodes (N): NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, including direct extension N2 Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s) N3 Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s) |
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Distant metastasis (M): MX Presence of distant metastasis cannot be assessed M0 No distant metastasis M1 Distant metastasis |
| T, primary tumor; N, regional lymph nodes; M, distant metastasis. |
| Source: From Crawford et al.,5 with permission. |