Chapter 085. Neoplasms of the Lung (Part 7) pptx

Neoplasms of the Lung Part 7 Table 85-2 Tumor, Node, Metastasis International Staging System for Lung Cancer Descriptors Clinical Stage Surgical-Pathologic Stage... TX Primary tumor

Chapter 085 Neoplasms of the Lung

(Part 7)

Table 85-2 Tumor, Node, Metastasis International Staging System for Lung Cancer

Descriptors

Clinical Stage

Surgical-Pathologic Stage

IIB T3 N0 M0 22 38

M0

IIIB T4 N0–1–2

M0

N3 M0

M1

Tumor (T) Status Descriptor

T0 No evidence of a primary tumor

TX Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy

TIS Carcinoma in situ

T1 Tumor <3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than lobar bronchus (i.e., not in main bronchus)

T2 Tumor with any of following: >3 cm in greatest dimension; involves main bronchus, ≥2 cm distal to the carina; invades visceral pleura; associated with atelectasis or obstructive pneumonitis extending to hilum but does not involve entire lung

T3 Tumor of any size that directly invades any of the following: chest wall (including superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium; or tumor in main bronchus

<2 cm distal to carina but without involvement of carina; or associated atelectasis or obstructive pneumonitis of entire lung

T4 Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or tumor with a malignant pleural or pericardial effusion,a or with satellite tumor nodule(s) within the ipsilateral primary-tumor lobe of the lung

Lymph Node (N) Involvement Descriptor

NX Regional lymph nodes cannot be assessed

N0 No regional lymph node metastasis

N1 Metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, and intrapulmonary nodes involved by direct extension

of the primary tumor

N2 Metastasis to ipsilateral mediastinal and/or subcarinal lymph node(s)

N3 Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)

Distant Metastasis (M) Descriptor

MX Presence of distant metastasis cannot be assessed

M0 No distant metastasis

M1 Distant metastasis presentb

a

Most pleural effusions associated with lung cancer are due to tumor However, in a few patients with multiple negative cytopathologic exams of a non-bloody, non-exudative pleural or pericardial effusion that clinical judgment dictates is not related to the tumor, the effusion should be excluded as a staging element and the patient's disease staged as T1, T2, or T3

b

Separate metastatic pulmonary tumor nodule(s) in the ipsilateral nonprimary tumor lobe(s) of the lung are classified as M1

Source: Adapted from CF Mountain Revisions in the International System

for Staging of Lung Cancer Chest 111:1710, 1997; with permission