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Update Series on Respiratory Nursing

Carcinoma of Lung ¡@
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UICC/AJCC International Staging System For Lung Cancer [10]
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Ca Lung

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TNM Definitions

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Primary Tumor (T) ¡@

TX:

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Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings but not visualized by imaging or bronchoscopy

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T0:

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No evidence of primary tumor

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Tis:

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Carcinoma in situ

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T1:

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A tumor that is 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, and without bronchoscopic evidence of invasion more proximal than the lcbar bronchus (i.e., not in the main bronchus)

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T2:

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A tumor with any of the following features of size or extent: More than 3 cm in greatest dimension, involves the main bronchus, 2 cm or more distal to the carina, invades the visceral pleura, associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung

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T3:

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A tumor of any size that directly invades any of the following: chest wall (including superior sulcus tumours), diaphragm, mediastinal pleura, parietal pericardium; or tumor in the main bronchus less than 2 cm distal to the carina but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung

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T4:

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A tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or separate tumor nodules in the same lobe; or tumor with a malignant pleural effusion 

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Regional Lymph Nodes (N)¡@

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NX:

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Regional lymph nodes cannot be assessed

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N1:

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Metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, and intrapulmonary nodes including involvement by direct extension of the primary tumor

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N2:

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Metastasis to ipsilateral mediastinal and/or subcarinal lymph node(s)

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N3:

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Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)

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Distant Metastasis (M)¡@

MX:

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Distant metastasis cannot be assessed

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M0:

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No distant metastasis

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M1:

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Distant metastasis present

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Specify sites according to the following notations:

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BRA = brain EYE = eye HEP = hepatic
LYM = lymph nodes MAR = bone marrow OSS = osseous
OTH = other OVR = ovary PER = peritoneal
PLE = pleura PUL = pulmonary SKI = skin
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Stage Groupings ¡@
Occult carcinoma TX, N0, M0
Stage 0 Tis, N0, M0
Stage IA T1, N0, M0
Stage IB T2, N0, M0
Stage IIA T1, N1, M0
Stage IIB

T2, N1,M0

Stage IIIA T3, N0, M0
T1, N2, M0
T2, N2, M0
T3, N1, M0
T3, N2, M0
Stage IIIB Any T, N3, M0
T4, Any N, M0
Stage IV AnyT, AnyN, M1
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