IASLC International Lung Cancer 7th Edition TNM Staging

  T Staging
  Tx: primary tumor cannot be evaluated; or sputum, bronchial washings find cancer cells but imaging
  or bronchoscopy did not visualize the tumor.
  T0: no evidence of primary tumor.
  Tis: carcinoma in situ.
  T1: tumor ≤3 cm in maximum diameter, surrounded by lung or dirty pleura, microscopic tumor
  did not involve more than lobar bronchus (i.e., did not involve main bronchus).
  ① T1a: the maximum diameter of the tumor is ≤2 cm.
  ② T1b: the maximum diameter of the tumor is 2-3 cm.
  T2: Tumor size or extent meets any of the following points.
  ① Tumor maximum diameter >3 cm and ≤7 cm.
  ② Involvement of main bronchus, but ≥2 cm from the bulge.
  ③Involvement of the dirty pleura.
  ④Spread to the hilum causing atelectasis or obstructive pneumonia (not involving the whole lung).
  ⑤ T2a: the maximum diameter of tumor is 3-5cm (or other factors cause T2 but the maximum tumor
  diameter ≤5cm).
  (6) T2b: the maximum diameter of the tumor is 5-7cm.
  T3: Tumor of any size, but directly invades any of the following areas.
  ① chest wall (including superior sulcus tumor), diaphragm, mediastinal pleura, wall pericardium.
  ②Tumor in the main bronchus, less than 2 cm from the bullae (without involving the bullae).
  ③Pulmonary atelectasis or obstructive inflammation of the whole lung.
  ④Tumor metastases in the same lobe.
  ⑤ The maximum diameter of the tumor is greater than 7 cm.
  T4: Regardless of the size of the tumor, but invading the following sites.
  ①Mediastinum, heart, large blood vessels, trachea, esophagus, vertebrae, and aorta.
  ②Tumor metastases in different lobes of the lung ipsilateral to the primary site.
  N stage
  Nx: unable to determine whether regional lymph node metastasis.
  N0: No regional lymph node metastasis .
  N1: Metastasis to ipsilateral paratracheal and/or ipsilateral hilar lymph nodes and direct invasion of the primary tumor into the lung
  The lymph nodes within the lung were directly invaded by the primary tumor.
  N2: Metastasis to the ipsilateral mediastinum and/or inferior bulbar lymph nodes.
  N3: Metastasis to the contralateral mediastinum, contralateral hilar lymph nodes, ipsilateral or contralateral ramus or supraclavicular lymph nodes.
  supra-limbar node.
  M staging
  Mx: No estimation of distant metastases.
  M0: No distant metastasis.
  M1a: malignant pleural fluid or malignant pericardial effusion.
  M1b: with distant metastasis (Note: metastatic nodes ipsilateral to the primary tumor but in different lung lobes are
  T4).
  TNM staging.
  Cryptogenic tumor
  TX
  N0
  M0
  Stage 0
  Tis
  N0
  M0
  M0
  T1a, b
  N0
  M0
  IB
  T2a
  N0
  M0
  IIA
  T1a, b
  N1
  M0
  T2a
  N1
  M0
  T2b
  N0
  M0
  IIB
  T2b
  N1
  M0
  T3
  N0
  M0
  IIIA
  T1, T2
  N2
  M0
  T3
  N1, N2
  M0
  T4
  N0, N1
  M0
  IIIB
  T4
  N2
  M0
  Any T
  N3
  M0
  IV
  Any T
  Any N
  M1a,b