Adenocarcinoma of the lung staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Adenocarcinoma of the lung may be classified into several subtypes based on TNM and UICC staging system.^[1]

TNM staging^[1]


TNM	Definition

TX	The primary tumour cannot be assessed, or there are malignant cells in the sputum or bronchoalveolar lavage but not seen on imaging or bronchoscopy.
T0	No evidence of primary tumor.
Tis	Carcinoma in situ.
T1	Tumour is 3 cm or less in size and has not spread to the visceral pleura or the main bronchi.
	T1a – Tumour is smaller than 2 cm.
	T1b – Tumour is larger than 2 cm, but smaller than 3 cm.
T2	A tumour with any of: More than 3 cm in greatest dimension; Extending into the main bronchus, but more than 2 cm distal to the carina; Obstructive pneumonitis, but not involving the entire lung.
T3	A tumour with any of: Invasion of the chest wall, diaphragm, mediastinal pleura, or parietal pericardium; Extending into the main bronchus, within 2 cm of the carina, but not involving the carina; Obstructive pneumonitis of the entire lung.
T4	A tumour with any of: Invasion of the mediastinum, heart, great vessels, trachea, oesophagus, vertebra, or carina; Separate tumour nodules in the same lobe; Malignant pleural effusion.
Regional Lymph Nodes
NX	Lymph nodes cannot be assessed.
N0	No lymph nodes involved.
N1	Metastasis to ipsilateral peribronchial or ipsilateral hilar lymph nodes.
N2	Metastasis to ipsilateral mediastinal or subcarinal lymph nodes.
N3	Metastasis to any of: Ipsilateral supraclavicular lymph nodes; Ipsilateral scalene lymph nodes; Contralateral lymph nodes.
Distant Metastasis
MX	Distant metastasis cannot be assessed.
M0	No distant metastasis.
M1	Distant metastasis is present.

UICC staging^[1]


Stage	T	N	M

Occult carcinoma	TX	N0	M0
Stage 0	Tis	N0	M0
Stage IA	T1	N0	M0
Stage IB	T2	N0	M0
Stage IIA	T1	N1	M0
Stage IIB	T2	N1	M0
Stage IIB	T3	N0	M0
Stage IIIA	T1	N2	M0
	T2	N2	M0
	T3	N1	M0
	T3	N2	M0
Stage IIIB	Any T	N3	M0
Stage IIIB	T4	Any N	M0
Stage IV	Any T	Any N	M1