Lung cancer (staging - IASLC 7th edition) (historical)
Updates to Article Attributes
Body
was changed:
Non-small cell lung cancer (NSCLC) staging can be accomplished both by the TNM system, or by the AJCC staging system.
For a general discussion of these tumours please refer to the article on non-small cell lung cancer (NSCLC).
TNM system
The current 7th edition January 2010 NSCLC staging is as follows 4:
Primary tumour (T)
- Tx: malignant cells on cytology but no tumour found on bronchoscopy or imaging.
- Tis: carcinoma in situ
-
T1
- tumour size equal or less than 3cm
-
not involving the main bronchus
- T1a: smaller than 2 cm in longest dimension
- T1b: larger than 2 cm but smaller or equal to 3 cm
-
T2:
>3 cm in-
tumour size
andmore than 3cm but less/equal to 7cm or -
involving the main bronchus but >2 cm from carina
, or - visceral pleural
involvement, orinvolvement - lobar atelectasis extending to the hilum but not collapse of the entire lung
- T2a: larger than 3 cm but smaller than 5 cm
- T2b: larger than 5 cm but smaller than 7 cm
-
tumour size
-
T3
- tumour size more than 7 cm or
- tumour <2 cm from carina but not involving trachea or carina
- involvement of the chest wall,
diaphragmincluding Pancoast tumour, diaphragm, phrenic nerve, mediastinal pleura or parietal pericardium, - separate tumour nodule(s) in the same lobe
- atelectasis or post obstructive pneumonitis of entire lung
-
T4
- any size tumour with:
- involvement of the trachea, oesophagus, recurrent laryngeal nerve vertebra, great vessels or heart
- separate tumour nodules in the same lung but not in the same lobe
Nodal status (N)
- Nx: regional nodes cannot be assessed
- N0: no regional nodal metastases
- N1: ipsilateral peribronchial, hilar or intrapulmonary nodes, including direct invasion
- N2: ipsilateral mediastinal or subcarinal nodes
- N3: contralateral nodal involvement ; ipsilateral or contralateral scalene or supraclavicular nodal involvement
Distant metastasis (M)
- Mx: distant metastases cannot be assessed
- M0: no distant metastases
-
M1: distant metastases present
-
M1a: presence of a malignant pleural or pericardial effusion, pleural dissemination, or pericardial disease,
intrathoracic metastases (metastasisand metastasis in opposite lung) - M1b: extrathoracic metastases
-
M1a: presence of a malignant pleural or pericardial effusion, pleural dissemination, or pericardial disease,
AJCC staging system
-
stage 0
- TNM equivalent: carcinoma in stiu
- resectable: yes
-
stage I
- TNM equivalent: T1 or T2, N0, M0
- resectable: yes
- 5 year survival: 47%
-
stage IIa
- TNM equivalent: T1, N1, M0
- resectable: yes
-
stage IIb
- TNM equivalent: T2, N1, M0 or T3, N0, M0
- resectable: yes
- 5 year survival: 26%
-
stage IIIa
- TNM equivalent: T1 or 2, N2, M0 or T3, N1 or 2, M0
- resectable: yes
--------------- accepted cut off between resectable and non resectable ----------
-
stage IIIb
- TNM equivalent: T1, 2 or 3, N3, M0 or T4, N0, 1, 2 or 3, M0
- resectable: no
- 5 year survival: 8%
-
stage IV
- TNM equivalent: any T, any N with M1
- resectable: no
- 5 year survival: 2%
Histological grade
- grade 1: well differentiated
- grade 2: moderately differentiated
- grade 3: poorly differentiated
- grade 4: undifferentiated
-<p><strong>Non-small cell lung cancer (NSCLC) staging</strong> can be accomplished both by the <a href="/articles/tnm-staging-system">TNM system</a>, or by the AJCC staging system.</p><p>For a general discussion of these tumours please refer to the article on <a href="/articles/non-small-cell-lung-cancer">non-small cell lung cancer (NSCLC)</a>.</p><h5>TNM system</h5><p>The current <strong> 7<sup>th</sup> edition</strong> NSCLC staging is as follows <sup>4</sup>:</p><h6>Primary tumour (T)</h6><ul>- +<p><strong>Non-small cell lung cancer (NSCLC) staging</strong> can be accomplished both by the <a href="/articles/tnm-staging-system">TNM system</a>, or by the AJCC staging system.</p><p>For a general discussion of these tumours please refer to the article on <a href="/articles/non-small-cell-lung-cancer">non-small cell lung cancer (NSCLC)</a>.</p><h5>TNM system</h5><p>The current <strong> 7<sup>th</sup> edition January 2010</strong> NSCLC staging is as follows <sup>4</sup>:</p><h6>Primary tumour (T)</h6><ul>
- +<li>tumour size equal or less than 3cm </li>
- +<li>not involving the main bronchus<ul>
- +</ul>
- +</li>
-<strong>T2:</strong> >3 cm in size and >2 cm from carina, or visceral pleural involvement, or lobar atelectasis<ul>- +<strong>T2:</strong> <ul>
- +<li>tumour size more than 3cm but less/equal to 7cm or</li>
- +<li>involving the main bronchus but >2 cm from carina</li>
- +<li>visceral pleural involvement</li>
- +<li>lobar atelectasis extending to the hilum but not collapse of the entire lung <ul>
- +</ul>
- +</li>
- +<li>tumour size more than 7 cm or </li>
-<strong></strong><2 cm from carina but not involving trachea or carina</li>-<li>involvement of chest wall, diaphragm, mediastinal pleura or parietal pericardium, separate tumour nodule(s) in the same lobe</li>- +<strong> </strong>tumour <strong></strong><2 cm from carina but not involving trachea or carina</li>
- +<li>involvement of the chest wall, including Pancoast tumour, diaphragm, phrenic nerve, mediastinal pleura or parietal pericardium</li>
- +<li>separate tumour nodule(s) in the same lobe</li>
- +<li>atelectasis or post obstructive pneumonitis of entire lung</li>
-<li>involvement of the trachea, oesophagus, vertebra, great vessels or heart </li>- +<li>any size tumour with:</li>
- +<li>involvement of the trachea, oesophagus, recurrent laryngeal nerve vertebra, great vessels or heart </li>
-<strong>N1:</strong> ipsilateral peribronchial, hilar or intrapulmonary nodes</li>- +<strong>N1:</strong> ipsilateral peribronchial, hilar or intrapulmonary nodes, including direct invasion</li>
-<strong>M1a:</strong> presence of a malignant pleural effusion, pleural dissemination, or pericardial disease, intrathoracic metastases (metastasis in opposite lung)</li>- +<strong>M1a:</strong> presence of a malignant pleural or pericardial effusion, pleural dissemination, or pericardial disease, and metastasis in opposite lung</li>