NCCN Guidelines for Patients
: Non-Small Cell Lung Cancer
Part 4: Lung cancer staging
4.2 TNM scores
The AJCC (
staging system is used to stage lung cancer. In this
system, the letters T, N, and M describe different areas
of cancer growth. Your doctors will assign a score to
each letter. These scores will be combined to assign the
cancer a stage.
T = Tumor
The T score tells how large or where the primary tumor
has grown. Figure 4 shows areas of tumor growth. In
medicine, tumors are measured in cm (
About 0.4 inch equals 1 cm. T scores for lung cancer
tumors are too small for testing or can’t be found
means there are abnormal cells in the bronchi
that haven’t invaded tissue.
tumors are in the lungs only and are not larger
than 3 cm.
tumors are 2 cm or smaller.
tumors are more than 2 cm but not larger
than 3 cm.
tumors: a) are larger than 3 cm but not larger
than 7 cm; b) have grown into the bronchus but not
closer than 2 cm to the carina; c) have grown into
the visceral pleura; or d) have caused atelectasis
or pneumonitis in part of the lung.
tumors are larger than 3 cm but not larger
than 5 cm with or without other features, or are
smaller in size with other features.
tumors are larger than 5 cm but not larger
than 7 cm with or without other features.
tumors: a) are larger than 7 cm; b) have grown
into the bronchus within 2 cm of the carina; c)
have grown into the parietal pleura, chest wall,
diaphragm, phrenic nerve, mediastinal pleura,
or outer pericardium; d) have caused atelectasis
or pneumonitis in the whole lung; or e) there are
secondary tumors in the same lobe as the primary
tumors are scored based on invasion or the
presence of secondary tumors. They: a) have
grown into the mediastinum, heart or its major
blood vessels, trachea, recurrent laryngeal nerve,
esophagus, spine, or carina; or (b) there are
secondary tumors in the lung with the primary tumor
but in a different lobe.