Table 5

TNM classification

Primary tumour (T)
 TxPrimary tumour cannot be assessed or tumour proven by the presence of malignant cells in sputum or bronchial washings but not visualised by imaging or bronchoscopy
T0No evidence of primary tumour
TisCarcinoma in situ
T1Tumour <3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus
T2Tumour with any of the following features of size or extent:
• >3 cm in greatest dimension
• involves main bronchus >2 cm distal to the carina
• invades the visceral pleura
• associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung
T3Tumour of any size that directly invades the following: chest wall (including superior sulcus tumours), diaphragm, mediastinal pleura, parietal pericardium; or tumour in the main bronchus <2 cm distal to the carina but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung
T4Tumour of any size that involves any of the following: mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or tumour with a malignant pleural or pericardial effusion, or with satellite tumour nodule(s) within the ipsilateral primary tumour lobe of the lung
Regional lymph nodes (N)
NxRegional lymph nodes cannot be assessed
N0No regional lymph node metastases
N1Metastases to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes involved by direct extension of primary tumour
N2Metastases to ipsilateral mediastinal and/or subcarinal lymph nodes
N3Metastases to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral saclene or supraclavicular lymph nodes
Distant metastases (M)
MxPresence of distant metastases cannot be assessed
M0No distant metastases
M1Distant metastases present
Stage grouping TNM subsets
0Carcinoma in situ
IAT1N0M0
IBT2N0M0
IIAT1N1M0
IIBT2N1M0
T3N0M0
IIIAT3N1M0
T1N2M0
T2N2M0
T3N2M0
IIIBT4N0M0
T4N1M0
T4N2M0
T1N3M0
T2N3M0
T3N3M0
T4N3M0
IVAny T Any N M1