Tumor, Node, Metastasis International Staging System for Lung Cancer
Comparison of Survival by Stage in TNM Sixth and Seventh Editions | |||
Stage | TNM Sixth Edition | TNM Seventh Edition | 5-Year Survival, %a |
IA | T1N0M0 | T1a-T1bN0M0 | 73 |
IB | T2N0M0 | T2aN0M0 | 58 |
IIA | T1N1M0 | T1a-T2aN1M0 or | 46 |
T2bN0M0 | |||
IIB | T2N1M0 or | T2bN1M0 or | 36 |
T3N0M0 | T3N0M0 | ||
IIIA | T3N1M0 or | T1a-T3N2M0 or | 24 |
T1-3N2M0 | T3N1M0 or | ||
T4N0-1M0 | |||
IIIB | Any T N3M0 | T4N2M0 or | 9 |
T4 Any N M0 | T1a-T4N3M0 | ||
IV | Any T Any N M1 | Any T Any N M1a or M1b | 13 |
Sixth Edition | Seventh Edition | ||
Tumor (T) | |||
T1 | Tumor ≤3 cm diameter without invasion more proximal than lobar bronchus | Tumor ≤3 cm diameter, surrounded by lung or visceral pleura, without invasion more proximal than lobar bronchus | |
T1a | Tumor ≤2 cm in diameter | ||
T1b | Tumor >2 cm but ≤3 cm in diameter | ||
T2 | Tumor >3 cm diameter or tumor of any size with any of the following: | Tumor >3 cm but ≤7 cm with any of the following: | |
Visceral pleural invasion | Involves main bronchus, ≥2 cm distal to carina | ||
Atelectasis of less than entire lung | Invades visceral pleura | ||
Proximal extent at least 2 cm from carina | Associated with atelectasis or obstructive pneumonitis extending to hilar region but not involving the entire lung | ||
T2a | Tumor >3 cm but ≤5 cm in diameter | ||
T2b | Tumor >5 cm but ≤7 cm in diameter | ||
T3 | Tumor of any size that invades any of the following: chest wall, diaphragm, mediastinal pleura, parietal pericardium | Tumor >7 cm or directly invades any of the following: chest wall (including superior sulcus tumors), phrenic nerve, mediastinal pleura, parietal pericardium | |
Tumor <2 cm distal to carina | Tumor <2 cm distal to carina but without involvement of carina | ||
Tumor with associated atelectasis or obstructive pneumonitis of entire lung | |||
Separate tumor nodule(s) in same lobe | |||
T4 | Tumor of any size that invades any of the following: mediastinum, heart or great vessels, trachea, esophagus, vertebral body, carina | Tumor of any size that invades any of the following: mediastinum, heart or great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina | |
Tumor with malignant pleural or pericardial effusion | Separate tumor nodule(s) in a different ipsilateral lobe | ||
Separate tumor nodules in same lobe | |||
Nodes (N) | |||
N0 | No regional lymph node metastasis | No regional lymph node metastasis | |
N1 | Metastasis in ipsilateral peribronchial and/or hilar lymph node(s) | Metastasis in ipsilateral peribronchial and/or hilar lymph node(s) and intrapulmonary node(s), including involvement by direct extensions | |
N2 | Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s) | 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) | Metastasis in contralateral mediastinal, hilar, ipsilateral or contralateral scalene or supraclavicular lymph node(s) | |
Metastasis (M) | |||
M0 | No distant metastasis | No distant metastasis | |
M1 | Distant metastasis (includes tumor nodules in different lobe from primary) | Distant metastasis | |
M1a | Separate tumor nodules in a contralateral lobe | ||
Tumor with pleural nodules or malignant pleural or pericardial effusion | |||
M1b | Distant metastasis |
aSurvival according to the seventh edition.
Abbreviation: TNM, tumor-node-metastasis.
Source: Bottom portion of table reproduced with permission from P Goldstraw et al: J Thorac Oncol 2:706, 2007.