The criteria are:
Size
The size of tumor is an important criterion:
- T0 - No evidence of primary tumor.
- T1 - A tumor that is 3.0 cm or less in greatest diameter
- T2 - A tumor more than 3.0 cm in greatest diameter
Proximity of Carina
- T3: A tumor bronchoscopically demonstrable to involve a
main bronchus less than 2.0 cm distal to but not involving carina should be
categorized as T3.
- T4: If the lesion involves carina it is staged as T4.
Note that resection of tumor with bronchial margin free of tumor
is not possible if the lesion is within 2cms from carina.
Extent of Collapse
- T2 - Lobar atelectasis or obstructive pneumonoa extending
to the hilar region.
- T3 - Any tumor associated with atelectasis or obstructive
pneumonotis of an entire lung.
Invasion of Surrounding Structures
- T2: Invades visceral pleura.
- T3: Direct extension to chest wall, diaphragm, or the
mediastinal pleura or pericardium.
- T4: Involving heart, great vessels, trachea, esophagus,
vertbral body.
| T Numerical Suffix Assignment |
| |
Size |
Proximity to Carina |
Extent of Collapse/Pneumo |
Invasion of Surrounding Structure |
| T1 |
< 3 cm |
- |
- |
- |
| T2 |
> 3 cm |
- |
Lobar atelectasis |
Visceral pleura |
| T3 |
- |
Within 2 cm from carina |
Entire lung |
Chest wall, diaphragm, mediastinal pleura, pericardium |
| T4 |
- |
Involving carina |
- |
Heart, great vessels, trachea, esophagus, vertebral body |
T Stage
I am going to give you
information about T characteristics of a hypothetical case.
- 2cm mass RUL
- Lesion in RUL; Right main stem bronchus normal
- No collapse
- No demonstrable chest wall extension
Assign "T" suffix for this patient. Is it T0, T1,
T2 or T3 ?
Answer
"T1" is the correct stage in this patient . Let us
review AJC classification of T staging:
- TX
- Tumor either proven by the presence of malignant cells in
bronchopulmonary secretions but not visualized bronchoscopically or
roentgenographically or cannot be assessed.
- T0
- No evidence of primary tumor.
- Tis
- Carcinoma in situ.
- T1
- A tumor that is 3.0 cm or less in greatest diameter,
surrounded by lung or visceral pleura, and without evidence of invasion
proximal to a lobar bronchus at bronchoscopy.
- T2
- A tumor more than 3.0 cm in greatest diameter or a tumor of
any size that either invades the visceral pleura or has associated
atelectasis or obstructive pneumonitis extending to the hilar region. At
bronchoscopy, the proximal extent of demonstrable tumor must be within a
lobar bronchus or at least 2.0 cm distal to the carina.
- T3
- Tumor of any size with direct extension into an adjacent
structure such as the parietal pleura or chest wall the diaphragm, or the
mediastinal pleura or pericardium; a tumor bronchoscopically demonstrable to
involve a main bronchus less than 2.0 cm distal to but not involving carina.
- T4
- A tumor of any size with invation of the mediastinum or
involving heart, great vessels, trachea, esophagus, vertebral body or carina
or presence of malignant pleural effusion.