What is the staging for primary tumor (T) involvement in non–small cell lung cancer (NSCLC)?

Updated: Jul 15, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Primary tumor (T) involvement is as follows:

  • Primary tumor (T) involvement is as follows:

  • TX - Primary tumor cannot be assessed

  • T0 - No evidence of primary tumor

  • Tis - Carcinoma in situ; squamous cell carcinoma in situ; adenocarcinoma in situ; adenocarcinoma with pure lepidic pattern, 3 cm or less in greatest dimension

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

  • T1mi - Minimally invasive adenocarcinoma: adenocarcinoma (3 cm or less in greatest dimension) with a predominantly lepidic pattern and 5 mm or less invasion in greatest dimension

  • T1a - Tumor 1 cm or less in greatest dimension

  • T1b - Tumor more than 1 cm but 2 cm or less

  • T1c - Tumor more than 2 cm but 3 cm or less

  • T2 - Tumor more than 3 cm but 5 cm or less, or one with any of the following features:(1) Involves the main bronchus, regardless of distance to the carina, but without involvement of the carina; (2) Invades visceral pleura (PL1 or PL2); (3) Associated with atelectasis or obstructive pneumonitis that extends to the hilar region, involving part or all of the lung

  • T2a - Tumor more than 3 cm but 4 cm or less

  • T2b - Tumor more than 4 cm but 5 cm or less

  • T3 - Tumor more than 5 cm but 7 cm or less, or one that invades any of the following: : parietal pleura (PL3), chest wall (including superior sulcus tumors), phrenic nerve, parietal pericardium; or separate tumor nodule(s) in the same lobe as the primary 

  • T4 - Tumor more than 7 cm, or of any size that invades one or more of the following: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina; separate tumor nodule(s) in an ipsilateral lobe different from that of the primary

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