Download Supplemental Digital Content 3. TNM System

Supplemental Digital Content 3. TNM System-Cancer Staging
The TNM staging system is based on the extent of the tumor (T), whether cancer cells have
spread to nearby (regional) lymph nodes (N), and whether distant (to other parts of the body)
metastasis (M) has occurred
TX
Primary tumor
cannot be
evaluated
NX
Regional lymph
nodes cannot be
evaluated
MX
T0
No evidence of
primary tumor
N0
No regional lymph
node involvement
M0
No distant metastasis
Tis
Carcinoma in situ
(CIS; abnormal
cell are present
and have not
invaded
neighboring
tissue.
T1,T2,T3, T4
Size and/or
extent of the
primary tumor
N1, N2, N3
Involvement of
regional lymph
nodes (number of
lymph nodes and/or
extent of spread)
M1
Distant metastasis is
present
National
Institute, 2010b.
Distant metastasis
cannot be evaluated
Cancer