Lung (ICD10 C34)

TX

N0

M0

Tis

N0

M0

T1

N0

M0

T1mi

N0

M0

T1a

N0

M0

T1b

N0

M0

T1c

N0

M0

T2a

N0

M0

T2b

N0

M0

T1a-c, T2a,b

N1

M0

T3

N0

M0

T1a-c, T2a,b

N2

M0

T3

N1

M0

T4

N0, N1

M0

T1a-c, T2a,b

N3

M0

T3, T4

N2

M0

T3, T4

N3

M0

Any T

Any N

M1

Any T

Any N

M1a, M1b

Any T

Any N

M1c

TX

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

T0

No evidence of primary tumour

Tis

Carcinoma in situ

T1

Tumour 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)

T1mi - Minimally invasive adenocarcinoma

T1a - Tumour 1 cm or less in greatest dimension

T1b - Tumour more than 1 cm but not more than 2 cm in greatest dimension

T1c - Tumour more than 2 cm but not more than 3 cm in greatest dimension

T2

Tumour more than 3 cm but not more than 5 cm; or tumour with any of the following features

•            Involves main bronchus regardless of distance to the carina, but without involvement of the carina

•            Invades visceral pleura

•            Associated with atelectasis or obstructive pneumonitis that extends to the hilar

T2a - Tumour more than 3 cm but not more than 4 cm in greatest dimension

T2b - Tumour more than 4 cm but not more than 5 cm in greatest dimension

T3

Tumour more than 5 cm but not more than 7 cm in greatest dimension or one that directly invades any of the following: parietal pleura, chest wall (including superior sulcus tumours) phrenic nerve, parietal pericardium; or separate tumour nodule(s) in the same lobe as the primary

T4

Tumour more than 7 cm or of any size that invades any of the following: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, oesophagus, vertebral body, carina; separate tumour nodule(s) in a different ipsilateral lobe to that of the primary

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by 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)

M0

No distant metastasis

M1

Distant metastasis

M1a - Separate tumour nodule(s) in a contralateral lobe; tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion

M1b - Single extrathoracic metastasis in a single organ

M1c - Multiple extrathoracic metastasis in a single or multiple organs

pN0

Histological examination of hilar and mediastinal lymphadenectomy specimen(s) will ordinarily include 6 or more lymph nodes/stations. Three of these nodes/stations should be mediastinal, including the subcarinal nodes and three from N1 nodes/stations. Labelling according to the IASLC chart and table of definitions given in the TNM Supplement is desirable. If all the lymph nodes examined are negative, but the number ordinarily examined is not met, classify as pN0.