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TNM stages of lung cancer
TNM stands for Tumour, Node, Metastases. This staging system describes
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
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The size of the tumour (T)
Whether cancer cells have spread into the lymph nodes (N) close to the cancer
And whether the cancer cells have spread anywhere else in the body, metastases
(M)
From early 2010, a revised TNM staging system was introduced world wide. We describe
the new system below.
Tumour (T)
The T stages for lung cancer are
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T1a – the tumour is contained within the lung and is smaller than 2cm across
T1b – the tumour is contained within the lung and is between 2 and 3 cm across
T2 – the tumour is between 3 and 7cm across or has grown into the largest airway
(the main bronchus) more than 2cm below the part where it divides to go into each lung or
the tumour has grown into the inner lining of the chest cavity (the visceral pleura) or the
tumour has made part of the lung collapse. T2 tumours that are 5cm or smaller are classed
as T2a and those larger than 5cm are T2b
T3 – the tumour is larger than 7cm or has grown into one of the following structures –
the chest wall, the central lining of the chest cavity (the mediastinal pleura), the muscle at
the bottom of the chest cavity (the diaphragm), or the outer covering of the heart (the
pericardium) or the tumour has made the whole lung collapse or there is more than one
tumour nodule in the same lobe of the lung
T4 – the tumour has grown into one of the following structures – the area between
the lungs in the middle of the chest (the mediastinum), the heart, a major blood vessel, the
wind pipe (trachea), the area where the main airway divides to go to each lung, the food
pipe (oesophagus), a spinal bone, the nerve that controls the voice box, or there are
tumour nodules in more than one lobe of the same lung
Nodes (N)
The N stages for lung cancer are
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N0 – there is no cancer in any lymph nodes
N1 – there is cancer in the lymph nodes nearest the affected lung
N2 – there is cancer in lymph nodes in the centre of the chest (mediastinum) but on
the same side as the affected lung or there is cancer in lymph nodes just under where the
windpipe branches off to each lung
N3 – there is cancer in lymph nodes on the opposite side of the chest from the
affected lung or in the lymph nodes above either collar bone or in the lymph nodes at the
top of the lung
Metastases (M)
The M stages for lung cancer are


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M0 – there are no signs that the cancer has spread to another lobe of the lung or any
other part of the body
M1a – there are tumours in both lungs or fluid around the lung or heart that contains
cancer cells (a malignant pleural effusion or pericardial effusion)
M1b – there are lung cancer cells in distant parts of the body, such as the liver or
bones