Lung Cancer Stages
The TNM classification system which developed by American Joint Committee on Cancer (AJCC) and the Union Internationale Contre le Cancer (UICC) is used for lung cancer staging. According to this system; T is tumor size, N is node involvement, and M means metastasis. The TNM staging system is used for patients with non-small cell lung carcinoma (NSCLC).
Primary Tumor (T)
T0: No primary tumor
Tis: Carcinoma in situ
T1: Tumor 3 centimeters or less (< 3 cm), surrounded by lung or visceral pleura, not more proximal than the lobar bronchus. T2: Tumor more than 3 centimeters (> 3 cm), invades visceral pleura, involves main bronchus 2 centimeters or more distal to the carina, atelectasis/obstructive pneumonia extending to hilum but not involving the entire lung.
T3: Tumor of any size that directly invades the chest wall, diaphragm, phrenic nerve, mediastinal pleura, or pericardium, or tumor that involves the main stem bronchus less than 2 centimeters (< 2 cm) distal to the carina, or atelectasis/obstructive pneumonitis of entire lung; or separate tumor nodules in the same lobe
T4: Tumor of any size with invasion of heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina or separate tumor nodules in a different ipsilateral lobe
Regional lymph nodes (N)
N0: No regional node metastasis
N1: Metastasis in ipsilateral peribronchial and/or perihilar 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 (M)
M0: No distant metastases
M1: Distant metastases are present
Staging of Non-Small Cell Lung Cancer
Types of non-small cell lung cancer are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. It is used the same system of staging and similar treatments and prognoses for these types. Non-small cell lung cancer is 80% of all lung cancer types.
Non-Small Cell Lung Cancer Stages
Non-small cell lung cancer stages include:
• Stage 1: The cancer is found in only one lung small and localized (not spread to any lymph nodes). Stage 1A (tumors 3 cm or less), stage 1B (tumors greater than 3 cm)
• Stage 2: The cancer has spread to nearby lymph nodes.
• Stage 3A: The cancer has enlarged into lymph nodes in the tracheal area (nodes in the middle of the chest-mediastinum).
• Stage 3B: The tumor has spread to distant lymph nodes.
• Stage 4: The cancer has spread to other parts of the body such as the liver, bones or the brain. 40% of all patients with non-small-cell lung cancer are diagnosed at lung cancer stage 4.
Staging of Small Cell Lung Cancer
Small cell lung cancers are divided into two stages:
• Limited disease: The cancer is present only in one lung, in close to lymph nodes, or in pleural effusion. One-third of patients with small cell lung cancer have limited disease.
• Extensive disease: The cancer has spread outside the lung, within the chest or to or to more distant locations in the body.
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