{"id":2564,"date":"2009-02-28T20:30:04","date_gmt":"2009-02-28T20:30:04","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/pullungc\/"},"modified":"2025-05-14T19:11:51","modified_gmt":"2025-05-14T19:11:51","slug":"pullungc","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/pullungc\/","title":{"rendered":"Tumor, Node, Metastasis International Staging System for Lung Cancer"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The Tumor, Node, Metastasis (TNM) staging system for lung cancer is an internationally accepted system used to characterize the extent of disease. The TNM system combines features of the tumor into disease stage groups that correlate with survival and are linked to recommendations for treatment.<br \/>\n<!--more--><\/p>\n<table class=\"MsoTableGrid\" style=\"border-collapse: collapse; height: 148px; width: 93.1611%;\" border=\"1\" width=\"455\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td style=\"border: 1pt solid windowtext; padding: 0cm 5.4pt; width: 13.245%;\" rowspan=\"2\" valign=\"top\">\n<p class=\"MsoNormal\"><span style=\"color: black;\"> Stage<\/span><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 24.9448%;\" rowspan=\"2\" valign=\"top\">\n<p class=\"MsoNormal\"><span style=\"color: black;\"> TNM Descriptors<\/span><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 119.605%;\" colspan=\"2\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\"><span style=\"color: black;\"> 5-Year Survival Rate, %<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 30.0221%;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\"><span style=\"color: black;\"> Clinical Stage<\/span><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 89.5827%;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\"><span style=\"color: black;\"> Surgical-Pathologic Stage<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 13.245%;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IA<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IB <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IIA<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IIB <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IIB<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IIIA<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IIIB<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> IV<\/span><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 24.9448%;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T1 N0 M0 <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T2 N0 M0 <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T1 N1 M0 <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T2 N1 M0 <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T3 N0 M0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T3 N1 M0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T1\u20132\u20133 N2 M0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T4 N0\u20131\u20132 M0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> T1\u20132\u20133\u20134 N3 M0 <\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> Any T any N M1<\/span><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 30.0221%;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 61<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 38<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 34<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 24<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 22<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 9<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 13<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">7<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">3<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">1<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 89.5827%;\" align=\"center\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 67<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 57<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 55<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 39<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 38<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 25<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> 23<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">&lt;5<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">&lt;3<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">&lt;1<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\" align=\"justify\"><span style=\"color: black; font-weight: bold;\">TUMOR (T) STATUS <\/span><\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>T0<\/strong> No evidence of a primary tumor<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>TX<\/strong> 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 bronchoscopy<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>TIS<\/strong> Carcinoma in situ<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>T1<\/strong> Tumor <\/span> &lt;<span style=\"color: black;\">3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than lobar bronchus (i.e., not in main bronchus)<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>T2<\/strong> Tumor with any of following: <\/span> &gt;<span style=\"color: black;\">3 cm in greatest dimension; involves main bronchus, <\/span> <span style=\"text-decoration: underline;\">&gt;<\/span><span style=\"color: black;\">2 cm distal to the carina; invades visceral pleura; associated with atelectasis or obstructive pneumonitis extending to hilum but does not involve entire lung<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>T3<\/strong> 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 <\/span> &lt;<span style=\"color: black;\">2 cm distal to carina but without involvement of carina; or associated atelectasis or obstructive pneumonitis of entire lung<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>T4<\/strong> 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<sup>a<\/sup>, or with satellite tumor nodule(s) within the ipsilateral primary-tumor lobe of the lung.<\/span><\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" align=\"justify\"><span style=\"color: black; font-weight: bold;\">LYMPH NODE (N) INVOLVEMENT <\/span><\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>NX <\/strong>Regional lymph nodes cannot be assessed<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>N0 <\/strong>No regional lymph node metastasis<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>N1<\/strong> Metastasis to ipsilateral peribronchial and\/or ipsilateral hilar lymph nodes, and intrapulmonary nodes involved by direct extension of the primary tumor<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>N2<\/strong> Metastasis to ipsilateral mediastinal and\/or subcarinal lymph nodes(s)<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>N3 <\/strong>Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)<\/span><\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" align=\"justify\"><span style=\"color: black; font-weight: bold;\">DISTANT METASTASIS (M) <\/span><\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>MX<\/strong> Presence of distant metastasis cannot be assessed<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>M0<\/strong> No distant metastasis<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\"><span style=\"color: black;\"> <strong>M1<\/strong> Distant metastasis present<sup>b<\/sup><\/span><\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" align=\"justify\"><sup><span style=\"color: black;\">a<\/span><\/sup><span style=\"color: black;\"> 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 judgment dictates is not related to the tumor, the effusion should be excluded as a staging element and the patient\u2019s disease staged as T1, T2, or T3.<\/span><\/p>\n<p class=\"MsoNormal\" align=\"justify\"><sup> <span style=\"color: black;\"> b<\/span><\/sup><span style=\"color: black;\"> Separate metastatic pulmonary tumor nodule(s) in the ipsilateral nonprimary tumor lobe(s) of the lung are classified as M1.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" align=\"justify\">Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest. 1997 Jun;111(6):1710-7. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9187198\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/p>\n<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Jun 18, 2007<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[272],"tags":[322,1071,1304,1065,588,1051,1723,1405,1722,29,835,507,816],"class_list":["post-2564","post","type-post","status-publish","format-standard","hentry","category-oncology","tag-cancer","tag-estadio","tag-internacional","tag-international","tag-lung","tag-metastasis","tag-node","tag-oncology","tag-pulmona","tag-pulmonary","tag-staging","tag-system","tag-tumor"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2564"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2564\/revisions"}],"predecessor-version":[{"id":9092,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2564\/revisions\/9092"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2564"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2564"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}