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LUNG CANCER
A Handbook for Staging, Imaging, and Lymph Node Classification
by Clifton F. Mountain, MD; Herman I. Libshitz, MD; and Kay E. Hermes
Contents | About the Author(s) | Dedication and Acknowledgment
 The Revised Staging System for Lung Cancer
page 5 

TNM DEFINITIONS
T - Primary Tumor

TX
Tumor proven by the presence of malignant cells in bronchopulmonary secretions but not visualized roentgenographically or bronchoscopically, or any tumor that cannot be assessed, as in a retreatment staging.
T0
No evidence of primary tumor.
TIS
Carcinoma in situ.
T1
A tumor that is 3.0 cm or less in greatest dimension, surrounded by lung or visceral pleura, and without evidence of invasion proximal to a lobar bronchus at bronchoscopy.*
T2
A tumor more than 3.0 cm in greatest dimension, or a tumor of any size that either invades the visceral pleura or has associated atelectasis or obstructive pneumonitis extending to the hilar region. At bronchoscopy, the proximal extent of demonstrable tumor must be within a lobar bronchus or at least 2.0 cm distal to the carina. Any associated atelectasis or obstructive pneumonitis must involve less than an entire lung.
T3
A tumor of any size with direct extension into the chest wall (including superior sulcus tumors), diaphragm, or the mediastinal pleura or pericardium without involving the heart, great vessels, trachea, esophagus or vertebral body, or a tumor in the main bronchus within 2 cm of the carina without involving the carina, or associated atelectasis or obstructive pneumonitis of entire lung.
T4
A tumor of any size with invasion of the mediastinum or involving heart, great vessels, trachea, esophagus, vertebral body or carina or presence of malignant pleural or pericardial effusion,** or with satellite tumor nodules within the ipsilateral, primary tumor lobe of the lung.

Copyright © 1999 - 2003 by CF Mountain and HI Libshitz, Houston, Texas. All rights reserved.

Printed in the United States of America by Charles P. Young Company. No part of this manual may be reproduced by any means without the prior written consent of the authors.