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转自丁香园

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Revised International System for Staging Lung Cancer (1997)

Staging of Non-Small Cell Lung Cancer


T0 No evidence of a primary tumor.

TX 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.

TIS Carcinoma in situ.

T1 Tumor <3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (ie, not in the main bronchus).

T2 Tumor with any of the following features of size or extent:

>3 cm in greatest dimension
Involves main bronchus, 2 cm distal to the carina
Invades the visceral pleura
Associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung.

T3
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 the main bronchus <2 cm distal to the carina, but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung.

T4
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, or with satellite tumor nodule within the ipsilateral primary-tumor lobe of the lung.

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T3 A tumor of any size with direct extension into (a) the chest wall (b) including superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium; or tumor in the main bronchus <2cm distal to the carina, but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung

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T3 A tumor of any size with direct extension into the chest wall (including superior sulcus tumors)...without involving the vertebral body.

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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 effusion.

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T4 A tumor of any size with invasion of a vertebral body. (unresectable - a true Pancoast&#39;s Syndrome).

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Nodal Involvement

N0 No regional lymph node metastasis.

N1 Metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, and intrapulmonary nodes involved by direct extension of the primary tumor.

N2
Metastasis to ipsilateral mediastinal and/or subcarinal lymph nodes

N3
Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node.

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Metastases

M0 No known distant metastasis.

M1 Distant metastasis present.

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N2 Metastasis to the ipsilateral mediastinal and/or subcarinal lymph node(s).

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N3 Metastasis to:
(a) ipsilateral or contralateral scalene, or supraclavicular lymph node(s).
(b) contralateral mediastinal or contralateral hilar lymph node(s).

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NSCLC Stage

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Stage IA cancers involve lesions completely contained within the lung without evidence of nodal or distant metastatic involvement. They are classified as T1 N0 M0.

Surgery represents the primary form of treatment for these patients. The outcome of the resection is not significantly improved by the administration of adjuvant therapy. The long term 5 year survival rate for patients surgically staged as stage IA is 67%.

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Stage IB cancers are defined as lesions contained completely within the lung without evidence of nodal or distant metastatic involvement. They are classified as T2 N0 M0.

Surgery represents the primary form of treatment for these patients. The outcome of the resection is not significantly improved by the administration of adjuvant therapy. The long term 5 year survival rate for patients surgically staged as stage IB is 57%.

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Stage IIA cancers are defined by lesions contained entirely within the lung with local ipsilateral lymph node involvement, but no distant metastases. They are classified as T1 N1 M0.

Surgery represents the primary form of treatment for these patients. The outcome of the resection is not significantly improved by the administration of adjuvant therapy. The long term 5 year survival rate for patients surgically staged as stage IIA is 55%.

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Stage IIB is defined by lesions classified as either T2 N1 M0 or T3 N0 M0. The long term 5 year survival rate for patients surgically staged as stage IIB is 39%

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Stage IIIA is defined by lesions classified as T3 N1 M0 or T1-3 N2 M0. The long term 5 year survival rate for patients surgically staged as stage IIIA is 24%