TNM classification for lung cancer

Tumor classification
Tx: Primary tumor cannot be assessed (or tumor identified by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy)
Tis: Carcinoma in situ, SCC in situ, or adenocarcinoma in situ: adenocarcinoma with a pure lepidic pattern, ≤ 3 cm in greatest dimension
T1mi: Minimally invasive (≤ 5 mm invasion in greatest dimension) adenocarcinoma with a predominantly lepidic pattern, ≤ 3 cm in greatest dimension
T1a: Tumor ≤ 1 cm in greatest dimension; superficial, spreading tumor of any size with its invasive component limited to the bronchial wall and may extend proximally to the main bronchus is also classified as T1a
T1b: Tumor > 1 cm but ≤ 2 cm in greatest dimension
T1c: Tumor > 2 cm but ≤ 3 cm in greatest dimension
T2a: Tumor > 3 cm but ≤ 4 cm in greatest dimension (involving the main bronchus, regardless of the distance to the carina but not involving it; invading visceral pleura; associated with atelectasis or obstructive pneumonitis extending to hilar region, involving part or all of the lung)
T2b: Tumor > 4 cm but ≤ 5 cm in greatest dimension (involving the main bronchus, regardless of the distance to the carina but not involving it; invading visceral pleura; associated with atelectasis or obstructive pneumonitis extending to hilar region, involving part or all of the lung)
T3: Tumor > 5 cm but ≤ 7 cm in greatest dimension or directly invading any of the following: parietal pleura, chest wall (including superior sulcus tumors), phrenic nerve, and/or parietal pericardium; or separate additional tumor nodule in the same lobe
T4: Tumor > 7 cm or tumor of any size invading ≥ 1 of the following: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina; or separate additional tumor nodule in a different ipsilateral lobe
Lymph node classification
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 nodes
N3: Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes
Distant metastasis
M0: No distant metastasis
M1a: Separate tumor nodule in a contralateral lobe; tumor with pleural nodules or malignant pleural or pericardial effusion (excluding effusion not related to the tumor)
M1b: Single extrathoracic metastasis in a single organ (including involvement of a single nonregional node)
M1c: Multiple extrathoracic metastases in a single organ or in multiple organs
Stage cannot be fully assessed
Reference
Amin, M.B., Edge et al. AJCC Cancer Staging Manual. AJCC. 2017.
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