Bronchogenic Carcinoma

Staging of NSCLC:

Primary tumor
TX	primary tumor cannot be evaluated, or tumor proven only by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy
T0	no evidence of primary tumor
Tis	carcinoma in situ
T1	tumor < 3 cm, surrounded by lung or visceral pleura, without bronchosopic evidence of invasion proximal to the lobar bronchus
T2	tumor > 3 cm, or tumor of any size with one or more of the following characteristics: - infiltration of the visceral pleura - invades the main bronchus but > 2 cm distal to the main carina - atelectasis or obstructive pneumonitis that extends to the hilus but does not involve the entire lung and without pleural effusion
T3	tumor of any size with invasion of the chest wall including adjacent rib(s), diaphragm, mediastinal pleura, parietal pericardium, or tumor in the main bronchus < 2 cm distal to the carina; or tumor associated with atelectasis or obstructive pneumonitis of the entire lung
T4	tumor of any size that invades the heart, great vessels, trachea, carina, esophagus, vertebral body; or tumor with malignant pleural effusion, or separate tumor nodules in the same lobe as the primary tumor
Regional lymph nodes
NX	lymph node status cannot be evaluated
N0	no evidence of regional lymph node metastasis
N1	metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, including direct invasion
N2	metastasis to ipsilateral mediastinal and/or subcarinal lymph nodes
N3	metastasis to contralateral mediastinal, contralateral hilar, or ipsilateral and/or contralateral supraclavicular or scalene lymph nodes
Distant metastasis
MX	distant metastasis cannot be evaluated
M0	no evidence of distant metastasis
M1	distant metastasis, including separate tumor nodules in a different lobe (ipsilateral or contralateral)

Stage groupings based on TNM classification

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 T3	N1 N0	M0 M0
stage IIIA	T1 T2 T3	N2 N2 N1,N2	M0 M0 M0
stage IIIB	any T T4	N3 any N	M0 M0
stage IV	any T	any N	M1

Karnofsky scale:

Able to carry on normal activity and to work; no special care needed.	100	Normal no complaints; no evidence of disease.
	90	Able to carry on normal activity; minor signs or symptoms of disease.
	80	Normal activity with effort; some signs or symptoms of disease.
Unable to work; able to live at home and care for most personal needs; varying amount of assistance needed.	70	Cares for self; unable to carry on normal activity or to do active work.
	60	Requires occasional assistance, but is able to care for most of his personal needs.
	50	Requires considerable assistance and frequent medical care.
Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly.	40	Disabled; requires special care and assistance.
	30	Severely disabled; hospital admission is indicated although death not imminent.
	20	Very sick; hospital admission necessary; active supportive treatment necessary.
	10	Moribund; fatal processes progressing rapidly.
	0	Dead

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