A 60-year-old smoker has a spiculated 2.5 cm right upper lobe mass on CT with hilar and ipsilateral mediastinal lymph node enlargement but no contralateral nodes, pleural effusion, or distant metastases. According to TNM 8th edition, what is the stage?
- A Stage IIIA (T2aN2M0) ✓
- B Stage IIA (T2bN1M0)
- C Stage IIB (T2aN1M0)
- D Stage IIIB (T2aN3M0)
Correct answer: A. Stage IIIA (T2aN2M0)
Explanation
By TNM 8th edition for NSCLC: the 2.5 cm tumour = T2a (>2 cm, ≤3 cm). Ipsilateral mediastinal/subcarinal lymph nodes = N2. No distant metastases = M0. Therefore T2aN2M0 = Stage IIIA. N1 is ipsilateral hilar/peribronchial lymph nodes. N2 is ipsilateral mediastinal or subcarinal nodes. N3 is contralateral mediastinal/hilar or scalene/supraclavicular nodes. Stage IIIA (T-any N2 M0 or T3-4 N1 M0) is locally advanced but potentially resectable. Stage IIIB includes T-any N3 M0.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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