Page 30 - NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer

30 NCCN Guidelines for Patients®: Non-Small Cell Lung Cancer
Version 1.2013
Part 4: Lung cancer staging
4.2 TNM scores
The AJCC (American Joint Committee on Cancer)
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 (centimeters).
About 0.4 inch equals 1 cm. T scores for lung cancer
include:
• TX tumors are too small for testing or can’t be found
with tests.
• Tis means there are abnormal cells in the bronchi
that haven’t invaded tissue.
• T1 tumors are in the lungs only and are not larger
than 3 cm.
• T1a tumors are 2 cm or smaller.
• T1b tumors are more than 2 cm but not larger
than 3 cm.
• T2 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.
• T2a 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.
• T2b tumors are larger than 5 cm but not larger
than 7 cm with or without other features.
• T3 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
tumor.
• T4 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.