Version July 2025
| Primary tumor (T)* | |||
| T category | T criteria | ||
| TX | Primary tumor cannot be assessed Includes tumors proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy | ||
| T0 | No evidence of primary tumor | ||
| Tis | Carcinoma in situ Squamous cell carcinoma in situ (SCIS) Adenocarcinoma in situ (AIS): adenocarcinoma with pure lepidic pattern, ≤3 cm in greatest dimension | ||
| T1 | Tumor ≤3 cm in greatest dimension surrounded by lung or visceral pleura, or in a lobar or more peripheral bronchus | ||
| T1mi | Minimally invasive adenocarcinoma: adenocarcinoma (≤3 cm in greatest dimension) with a predominantly lepidic pattern and ≤5 mm invasion in greatest dimension | ||
| T1a | Tumor ≤1 cm in greatest dimension or Tumor of any size whose invasive component is limited to the bronchial wall and may extend proximal to the main bronchus, this is an uncommon, superficial spreading tumor | ||
| T1b | Tumor >1 cm but ≤2 cm in greatest dimension | ||
| T1c | Tumor >2 cm but ≤3 cm in greatest dimension | ||
| T2 | Tumor >3 cm but ≤5 cm in greatest dimension or Tumor ≤4 cm with one or more of the following features:
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| T2a | Tumor >3 cm but ≤4 cm in greatest dimension or Tumor ≤4 cm in greatest dimension with one or more of the following features:
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| T2b | Tumor >4 cm but ≤5 cm in greatest dimension with or without any of the following features:
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| T3 | Tumor >5 cm but ≤7 cm in greatest dimension or Tumor ≤7 cm with one or more of the following features:
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| T4 | Tumor >7 cm in greatest dimension or Tumor of any size with one or more of the following features:
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Primary tumor suffix
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| Regional lymph nodes (N)* | |||
| N category | N criteria | ||
| NX | Regional lymph nodes cannot be assessed | ||
| N0 | No tumor involvement of regional lymph node(s) | ||
| N1 | Tumor involvement of ipsilateral peribronchial, and/or ipsilateral hilar, and/or ipsilateral intrapulmonary lymph node station(s), including involvement by direct extension | ||
| N2 | Tumor involvement of ipsilateral mediastinal nodal station(s) and/or subcarinal lymph node station | ||
| N2a | Tumor involvement of a single ipsilateral mediastinal nodal station or of the subcarinal nodal station | ||
| N2b | Tumor involvement of multiple ipsilateral mediastinal nodal stations with or without involvement of the subcarinal nodal station | ||
| N3 | Tumor involvement of contralateral mediastinal, contralateral hilar, ipsilateral/contralateral scalene, or ipsilateral/contralateral supraclavicular lymph node station(s) | ||
Regional lymph nodes suffix
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| Distant metastasis (M)* | |||
| M category | M criteria | ||
| cM0 | No distant metastasis | ||
| cM1 | Distant metastasis | ||
| cM1a | Metastasis in pleural or pericardial nodules, and/or malignant pleural or pericardial effusions, and/or separate tumor nodule(s) in a contralateral lobe NOTE: Most pleural (pericardial) effusions with lung cancer are a result of the tumor. In a few patients, however, multiple microscopic examinations of pleural (pericardial) fluid are negative for tumor, and the fluid is nonbloody and not an exudate. If these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging descriptor. | ||
| cM1b | Single extrathoracic metastasis in a single organ system (including involvement of a single nonregional node) | ||
| cM1c | Multiple extrathoracic metastases in a single or multiple organ system(s) | ||
| cM1c1 | Multiple extrathoracic metastases in a single organ system For example, the skeleton is considered one organ. Several metastases in a single bone or several metastases in several bones are classified as M1c1. | ||
| cM1c2 | Multiple extrathoracic metastases in multiple organ systems | ||
| pM1 | Microscopic confirmation of distant metastasis | ||
| pM1a | Microscopic confirmation of metastasis in pleural or pericardial nodules, and/or malignant pleural or pericardial effusions, and/or separate tumor nodule(s) in a contralateral lobe NOTE: Most pleural (pericardial) effusions with lung cancer are a result of the tumor. In a few patients, however, multiple microscopic examinations of pleural (pericardial) fluid are negative for tumor, and the fluid is nonbloody and not an exudate. If these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging descriptor. | ||
| pM1b | Microscopic confirmation of single extrathoracic metastasis in a single organ system (including involvement of a single nonregional node) | ||
| pM1c | Microscopic confirmation of multiple extrathoracic metastases in a single or multiple organ system(s) | ||
| pM1c1 | Microscopic confirmation of multiple extrathoracic metastases in a single organ system For example, the skeleton is considered one organ. Several metastases in a single bone or several metastases in several bones are classified as M1c1. | ||
| pM1c2 | Microscopic confirmation of multiple extrathoracic metastases in multiple organ systems | ||
| AJCC prognostic stage group is assigned based on the stage classification and categories chosen.* | |||
| Prognostic stage groups | |||
| When T is... | And N is... | And M is... | Then the stage group is... |
| TX | N0 | M0 | Occult carcinoma |
| Tis | N0 | M0 | 0 |
| T1mi-T1a | N0 | M0 | IA1 |
| T1b | N0 | M0 | IA2 |
| T1c | N0 | M0 | IA3 |
| T2a | N0 | M0 | IB |
| T2b | N0 | M0 | IIA |
| T1 | N1 | M0 | IIA |
| T3 | N0 | M0 | IIB |
| T1 | N2a | M0 | IIB |
| T2a-T2b | N1 | M0 | IIB |
| T4 | N0 | M0 | IIIA |
| T3-T4 | N1 | M0 | IIIA |
| T1 | N2b | M0 | IIIA |
| T2-T3 | N2a | M0 | IIIA |
| T2-T3 | N2b | M0 | IIIB |
| T4 | N2a-N2b | M0 | IIIB |
| T1-T2 | N3 | M0 | IIIB |
| T3-T4 | N3 | M0 | IIIC |
| Any T | Any N | M1a-M1b | IVA |
| Any T | Any N | M1c1-M1c2 | IVB |
AJCC: American Joint Committee on Cancer; FNA: fine-needle aspiration; TNM: tumor, node, metastasis.
* AJCC data elements required for staging are identified with an asterisk.
