Chapter 085. Neoplasms of the Lung (Part 7)

Table 85-2 Tumor, Node, Metastasis International Staging System for Lung Cancer5-Year Survival Rate, %StageTNM Descriptors StageClinicalSurgicalPathologic StageIAT1 N0 M06167IBT2 N0 M03857IIAT1 N1 M03455IIBT2 N1 M02439IIBT3 N0 M02238IIIAT3 N1 M0925T1–2–3 M0N21323IIIB M0T4N0–1–27
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Chapter 085. Neoplasms of the Lung (Part 7) Chapter 085. Neoplasms of the Lung (Part 7) Table 85-2 Tumor, Node, Metastasis International Staging System forLung Cancer 5-Year Survival Rate, % Stage TNM Clinical Surgical- Descriptors Stage Pathologic Stage IA T1 N0 M0 61 67 IB T2 N0 M0 38 57 IIA T1 N1 M0 34 55 IIB T2 N1 M0 24 39IIB T3 N0 M0 22 38IIIA T3 N1 M0 9 25 T1–2–3 N2 13 23 M0IIIB T4 N0–1–2 7 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 bronchoscopyTIS Carcinoma in situT1 Tumor 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 lungT3 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 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 DescriptorNX Regional lymph nodes cannot be assessedN0 No regional lymph node metastasisN1 Metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, and intrapulmonary nodes involved by direct extension of the primary tumorN2 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 judgmentdictates is not related to the tumor, the effusion should be excluded as a stagingelement and the patients disease staged as T1, T2, or T3. b Separate metastatic pulmonary tumor nodule(s) in the ipsilateralnonprimary tumor lobe(s) of the lung are classified as M1. Source: Adapted from CF Mountain. Revisions in the International Systemfor Staging of Lung Cancer. Chest 111:1710, 1997; with permission.