Staging of NSCLC:
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
no evidence of primary tumor
carcinoma in situ
tumor < 3 cm, surrounded by lung or visceral pleura, without bronchosopic evidence of invasion proximal to the lobar bronchus
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
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
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
lymph node status cannot be evaluated
no evidence of regional lymph node metastasis
metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, including direct invasion
metastasis to ipsilateral mediastinal and/or subcarinal lymph nodes
metastasis to contralateral mediastinal, contralateral hilar, or ipsilateral and/or contralateral supraclavicular or scalene lymph nodes
distant metastasis cannot be evaluated
no evidence of distant metastasis
distant metastasis, including separate tumor nodules in a different lobe (ipsilateral or contralateral)
Stage groupings based on TNM classification
T1 T2 T3
N2 N2 N1,N2
M0 M0 M0
any T T4
N3 any N
Able to carry on normal activity and to work; no special care needed.
Normal no complaints; no evidence of disease.
Able to carry on normal activity; minor signs or symptoms of disease.
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.
Cares for self; unable to carry on normal activity or to do active work.
Requires occasional assistance, but is able to care for most of his personal needs.
Requires considerable assistance and frequent medical care.
Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly.
Disabled; requires special care and assistance.
Severely disabled; hospital admission is indicated although death not imminent.
Very sick; hospital admission necessary; active supportive treatment necessary.
Moribund; fatal processes progressing rapidly.
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