TNM staging system for lung cancer, 7th edition

The original information of this staging system.

T – Primary Tumour

  1. Tumor size (in its greatest dimension) (must choose one and only one)
    1. Primary tumour cannot be assessed, or tumour proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy
    2. No evidence of primary tumour
    3. Carcinoma in situ
    4. Tumour ≤ 2 cm
    5. Tumour > 2 cm, but ≤ 3 cm
    6. Tumour > 3 cm, but ≤ 5 cm
    7. Tumour > 5 cm, but ≤ 7 cm
    8. Tumour > 7 cm
  2. Tumor location
    1. Superficial spreading tumour of any size with its invasive component limited to the bronchial wall (regardless any extension to the main bronchus)
    2. Involves main bronchus, ≥ 2 cm distal to the carina
    3. Involves main bronchus, < 2 cm distal to the carina
    4. Involves carina
  3. Associated findings
    1. Pleura
      1. Invades beyond the elastic layer (PL1) or to the pleural surface (PL2) of visceral pleura
      2. Invades into any component of the parietal pleura (PL3)
    2. Atelectasis
      1. Associated with atelectasis or obstructive pnemonitis that extends to the hilar region
      2. Associated with atelectasis or obstructive pneumonitis of the entire lung
    3. Direct invasion to adjacent organ
      1. Chest wall (including superior sulcus tumours), diaphragm, phrenic nerve, mediastinal pleura, parietal pericardium
      2. Mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, oesophagus, vertebral body
    4. Separate pulmonary nodule(s) in the same lung as the primary tumour
      1. Presence of pulmonary nodule(s) in the same lobe
      2. Presence of pulmonary nodule(s) in a different lobe(s)
    5. Separate pulmonary nodule(s) in the contralateral lung
      1. Presence of pulmonary nodule(s) in the contralateral lung
    6. Pleural/pericardial effusion
      1. Presence of pleural nodules or malignant pleural or pericardial effusion

N – Regional Lymph Nodes (must choose one and only one)

    1. Regional lymph nodes cannot be assessed
    2. No regional lymph node metastasis
    3. Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension
    4. Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s)
    5. Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)

M – Distant Metastasis (must choose one and only one)

    1. Distant metastasis cannot be assessed
    2. No extrathoracic distant metastasis
    3. Presence of extrathoracic distant metastasis