ARCHETYPE TNM staging - Lung cancer (Sixth Edition) (openEHR-EHR-CLUSTER.tnm_staging-lung_cancer.v1)

ARCHETYPE ID	openEHR-EHR-CLUSTER.tnm_staging-lung_cancer.v1
Concept	TNM staging - Lung cancer (Sixth Edition)
Description	TNM Staging classification for lung cancer (Sixth edition) .
Use	Use only for the Sixth edition of TNM lung cancer classification.
Misuse	Not to be used for pleural mesothelioma, sarcoma or other rare lung tumours. Not to be used for other editions of TNM classification.
Purpose	To record the TNM staging classification for lung cancer (Sixth Edition).
References	Greene FL, Page DL, Fleming ID. et al, eds, for the American Joint Committee on Cancer. AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer-Verlag; 2002. American Joint Committee on Cancer. TNM schema files [Internet]. [cited 2009 Jul 27 ] Available from: http://www.cancerstaging.org/education/tnmschema/tnmschema.html
Copyright	copyright (c) 2009 openEHR Foundation
Authors	Author name: Dr Ian McNicoll Organisation: Ocean Informatics, UK Email: ian.mcnicoll@oceaninformatics.com Date originally authored: 27/07/2009
Other Details Language	Author name: Dr Ian McNicoll Organisation: Ocean Informatics, UK Email: ian.mcnicoll@oceaninformatics.com Date originally authored: 27/07/2009
Other Details (Language Independent)	References: Greene FL, Page DL, Fleming ID. et al, eds, for the American Joint Committee on Cancer. AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer-Verlag; 2002. American Joint Committee on Cancer. TNM schema files [Internet]. [cited 2009 Jul 27 ] Available from: http://www.cancerstaging.org/education/tnmschema/tnmschema.html MD5-CAM-1.0.1: E03215CDA1A9A90A2730E3949D0B36F7
Keywords	tumour, TNM, malignancy, cancer, staging, classification, lung, bronchial, lymph node, metastasis
Lifecycle	AuthorDraft
Language used	en
Citeable Identifier	1013.1.417
items
Clinical (cTNM)	Clinical (cTNM): Clinical TNM pre-treatment classification based on physical examination, imaging and biopsies.
Primary tumour (T)	Primary tumour (T): Clincal assessment of the primary tumour. at0.14::Tx [Primary tumour cannot be assessed.] at0.15::T0 [No evidence of primary tumour.] at0.16::Tis [Carcinoma in situ.] at0.17::T1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.] at0.18::T2 [Tumour >3cm in greatest dimension;or, Involves main bronchus, 2cm or more distal to the carina;or, Invades the visceral pleura; or, Associated with atelectasis of obstructive pneumonia that extends to the hilar region but does not involve entire lung.] at0.19::T3 [Tumour of any size that directly invades chest wall, diaphragm, mediastinal pleura, parietal pericardium; or, Tumour in main bronchus <2cm from carina; or, Tumour with associated atelectasis or obstructive pneumonitis involving the entire lung.] at0.20::T4 [Tumour of any size that invades mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or, Separate tumour nodules in same lobe; or,Tumour with malignant pleural effusion.]
Regional lymph nodes (N)	Regional lymph nodes (N): Clinical assessment of the regional lymph nodes. at0.21::NX [Regional nodes cannot be assessed.] at0.22::N0 [No metastasis to regional lymph nodes.] at0.23::N1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.] at0.24::N2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.] at0.25::N3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
Distant metastasis (M)	Distant metastasis (M): Clinical assessment of distant metastasis. at0.26::MX [Distant metastasis cannot be assessed.] at0.27::M0 [No distant metastasis.] at0.28::M1 [Distant metastasis present.]
Residual tumour (R)	Residual tumour (R): Clinical assessment of post-treatment residual tumour. at0026::RX [Presence of residual tumour cannot be assessed.] at0027::RO [No residual tumour.] at0028::R1 [Microscopic residual tumour.] at0029::R2 [Macroscopic residual tumour.]
Clinical staging	Clinical staging: The overall Clinical staging derived from each T, N and M component e.g T1aM0NX. May include additional TNM descriptors.
Clinical stage grouping	Clinical stage grouping: The TNM Clinical stage grouping. at0.33::Stage 0 [Tis N0 M0] at0.34::Stage IA [T1 N0 M0] at0.54::Stage IIIB [Any T N3 M0, T4 Any N M0] at0.35::Stage IB [T2 N0 M0] at0.36::Stage IIA [T1 N1 M0] at0.37::Stage IIB [T2 N1 M0 ; T3 N0 M0] at0.38::Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
Comment	Comment: A text comment on the Clinical staging.
Pathological (pTNM)	Pathological (pTNM): Pathological staging. Based on the clinical staging, results of prrocedures and pathological histo-pathological assessment.
Primary tumour (pT)	Primary tumour (pT): Pathological assessment of the primary tumour. at0.39::pTx [Primary tumour cannot be assessed.] at0.40::pT0 [No evidence of primary tumour.] at0.41::pTis [Carcinoma in situ.] at0.42::pT1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.] at0.43::pT2 [Tumour >3cm in greatest dimension; or, Involves main bronchus, 2cm or more distal to the carina; or, Invades the visceral pleura; or, Associated with atelectasis of obstructive pneumonia that extends to the hilar region but does not involve entire lung.] at0.44::pT3 [Tumour of any size that directly invades chest wall, diaphragm, mediastinal pleura, parietal pericardium; or, Tumour in main bronchus <2cm from carina; or, Tumour with associated atelectasis or obstructive pneumonitis involving the entire lung.] at0.45::pT4 [Tumour of any size that invades mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or, Separate tumour nodules in same lobe; or, Tumour with malignant pleural effusion.]
Regional lymph node (pN)	Regional lymph node (pN): Pathological assessment of the regional lymph nodes. at0.46::pNX [Regional nodes cannot be assessed.] at0.47::pN0 [No metastasis to regional lymph nodes.] at0.48::pN1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.] at0.49::pN2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.] at0.50::pN3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
Distant metastasis (pM)	Distant metastasis (pM): Pathological assessment of distant metastases. at0.51::pMX [Distant metastasis cannot be assessed.] at0.52::pM0 [No distant metastasis.] at0.53::pM1 [Distant metastasis present.]
Residual tumour (pR)	Residual tumour (pR): Pathological assessment of post-treatment residual tumour. at0031::RX [Presence of residual tumour cannot be assessed. ] at0032::RO [No residual tumour.] at0033::R1 [Microscopic residual tumour.] at0034::R2 [Macroscopic residual tumour.]
Histopathological grading (G)	Histopathological grading (G): TNM histopathological grading classification. at0038::GX [Grade of differentiation cannot be assessed.] at0039::G1 [Well differentiated.] at0040::G2 [Moderately differentiated.] at0041::G3 [Poorly differentiated.] at0042::G4 [Undifferentiated.]
Pathological staging	Pathological staging: The overall Pathological staging derived from each pT, pN and pM component. May include additional TNM descriptors.
Pathological stage grouping	Pathological stage grouping: The TNM Pathological stage grouping. at0.33::Stage 0 [Tis N0 M0] at0.34::Stage IA [T1 N0 M0] at0.54::Stage IIIB [Any T N3 M0, T4 Any N M0] at0.35::Stage IB [T2 N0 M0] at0.36::Stage IIA [T1 N1 M0] at0.37::Stage IIB [T2 N1 M0 ; T3 N0 M0] at0.38::Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
Comment	Comment: A text comment on the Pathological staging.
Other contributors	Heather Leslie,Ocean Informatics. Australia Cathy Richardson, NEHTA, Australia David McKillop, NEHTA, Australia Koray Atalag, University of Auckland, New Zealand
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