Lung cancer: Determination of the disease stage
Lung cancer, Determination of the disease stage, Depending on the extent of the tumor one speaks of different stages (stages of development, tumor stages) of the lung cancer. The exact assignment is the prerequisite for the right therapy to be initiated. The classification is carried out according to certain standards, which are mainly governed by three aspects:
- The size and extent of the tumor (T)
- The involvement of lymph nodes (N)
- The presence of metastases (M)
Therefore, the term TNM classification is used, which is an internationally valid system. The digits behind the letters indicate the extent of the tumor (T1-4), the number and position of the affected lymph nodes (N0-3) and the presence or absence of distant metastases (M0 and M1). If, for example, the doctor mentions the “T1 N0 M0” stage in the patient documentation, this is a small tumor without lymph node involvement and metastases that has not yet grown into the main bronchus.
In small cell lung carcinoma, the same classification should be used as in the non-small cell lung carcinoma. However, a different classification is often used. It distinguishes between limited disease and advanced disease. To a limited disease is when the tumor is limited to the lung. An advanced disease is referred to as when the cancer has spread outside the lungs to other tissues of the breast and other parts of the body.
TNM classification of lung cancer
For T (tumor) there are the following names:
- T1 = The primary tumor is less than 2 cm (T1a) or between 2 and 3 cm (T1b), the main bronchus is not infected.
- T2 = The primary tumor is larger than 3 cm and smaller than 5 cm (T2a) or between 5 and 7 cm (T2b) or grows into the main bronchus of the same side.
- T3 = The primary tumor is larger than 7 cm, or the thoracic wall, diaphragm, lung or rib fur, or a main bronchus; Or the primary tumor has placed satellite herds in the same lobe.
- T4 = The tumor detects adjacent structures such as the space between the two lungs (mediastinum), the heart, the blood vessels, the trachea, or the vertebral body, or the primary tumor has satellites in other lobes lying on the same side.
The designations for N (Nodi = nodes) are:
- N0 = The lymph nodes are not affected.
- N1 = The tumor detects lymph nodes in the lung or lung root of the same side.
- N2 = The tumor detects lymph nodes in the mediastinum (space between both lungs) on the same side.
- N3 = The tumor detects distant lymph nodes on the other side of the chest
For M (metastases) there are the following classification:
- M0 = no clinical detection of daughter tumors (metastases)
- (M1a), or a malignant infiltration of rib or lung pelvis (pleura), or of the pericardium, or separate tumors in the opposite lobe of the lung, is detectable (M1a).
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