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

ARCHETYPE IDopenEHR-EHR-CLUSTER.tnm_staging-lung_cancer.v1
ConceptTNM staging - Lung cancer (Sixth Edition)
DescriptionTNM Staging classification for lung cancer (Sixth edition) .
UseUse only for the Sixth edition of TNM lung cancer classification.
MisuseNot to be used for pleural mesothelioma, sarcoma or other rare lung tumours. Not to be used for other editions of TNM classification.
PurposeTo record the TNM staging classification for lung cancer (Sixth Edition).
ReferencesGreene 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
Copyrightcopyright (c) 2009 openEHR Foundation
AuthorsAuthor name: Dr Ian McNicoll
Organisation: Ocean Informatics, UK
Email: ian.mcnicoll@oceaninformatics.com
Date originally authored: 27/07/2009
Other Details LanguageAuthor name: Dr Ian McNicoll
Organisation: Ocean Informatics, UK
Email: ian.mcnicoll@oceaninformatics.com
Date originally authored: 27/07/2009
OtherDetails 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}
Keywordstumour, TNM, malignancy, cancer, staging, classification, lung, bronchial, lymph node, metastasis
LifecycleAuthorDraft
Language useden
Citeable Identifier1013.1.417
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Cathy Richardson, NEHTA, Australia
David McKillop, NEHTA, Australia
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  • Tx [Primary tumour cannot be assessed.]
  • T0 [No evidence of primary tumour.]
  • Tis [Carcinoma in situ.]
  • T1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.]
  • 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.]
  • 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.]
  • 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.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0004], code=at0004, itemType=ELEMENT, level=2, text=Regional lymph nodes (N), description=Clinical assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • NX [Regional nodes cannot be assessed.]
  • N0 [No metastasis to regional lymph nodes.]
  • N1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.]
  • N2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.]
  • N3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
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  • MX [Distant metastasis cannot be assessed.]
  • M0 [No distant metastasis.]
  • M1 [Distant metastasis present.]
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  • RX [Presence of residual tumour cannot be assessed.]
  • RO [No residual tumour.]
  • R1 [Microscopic residual tumour.]
  • R2 [Macroscopic residual tumour.]
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  • Stage 0 [Tis N0 M0]
  • Stage IA [T1 N0 M0]
  • Stage IIIB [Any T N3 M0, T4 Any N M0]
  • Stage IB [T2 N0 M0]
  • Stage IIA [T1 N1 M0]
  • Stage IIB [T2 N1 M0 ; T3 N0 M0]
  • Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
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  • pTx [Primary tumour cannot be assessed.]
  • pT0 [No evidence of primary tumour.]
  • pTis [Carcinoma in situ.]
  • pT1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.]
  • 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.]
  • 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.]
  • 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.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0008], code=at0008, itemType=ELEMENT, level=2, text=Regional lymph node (pN), description=Pathological assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • pNX [Regional nodes cannot be assessed.]
  • pN0 [No metastasis to regional lymph nodes.]
  • pN1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.]
  • pN2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.]
  • pN3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
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  • pMX [Distant metastasis cannot be assessed.]
  • pM0 [No distant metastasis.]
  • pM1 [Distant metastasis present.]
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  • RX [Presence of residual tumour cannot be assessed. ]
  • RO [No residual tumour.]
  • R1 [Microscopic residual tumour.]
  • R2 [Macroscopic residual tumour.]
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  • GX [Grade of differentiation cannot be assessed.]
  • G1 [Well differentiated.]
  • G2 [Moderately differentiated.]
  • G3 [Poorly differentiated.]
  • G4 [Undifferentiated.]
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  • Stage 0 [Tis N0 M0]
  • Stage IA [T1 N0 M0]
  • Stage IIIB [Any T N3 M0, T4 Any N M0]
  • Stage IB [T2 N0 M0]
  • Stage IIA [T1 N1 M0]
  • Stage IIB [T2 N1 M0 ; T3 N0 M0]
  • Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
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  • Tx [Primary tumour cannot be assessed.]
  • T0 [No evidence of primary tumour.]
  • Tis [Carcinoma in situ.]
  • T1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.]
  • 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.]
  • 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.]
  • 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.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0004], code=at0004, itemType=ELEMENT, level=2, text=Regional lymph nodes (N), description=Clinical assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • NX [Regional nodes cannot be assessed.]
  • N0 [No metastasis to regional lymph nodes.]
  • N1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.]
  • N2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.]
  • N3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002]/items[at0005], code=at0005, itemType=ELEMENT, level=2, text=Distant metastasis (M), description=Clinical assessment of distant metastasis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • MX [Distant metastasis cannot be assessed.]
  • M0 [No distant metastasis.]
  • M1 [Distant metastasis present.]
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  • RX [Presence of residual tumour cannot be assessed.]
  • RO [No residual tumour.]
  • R1 [Microscopic residual tumour.]
  • R2 [Macroscopic residual tumour.]
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  • Stage 0 [Tis N0 M0]
  • Stage IA [T1 N0 M0]
  • Stage IIIB [Any T N3 M0, T4 Any N M0]
  • Stage IB [T2 N0 M0]
  • Stage IIA [T1 N1 M0]
  • Stage IIB [T2 N1 M0 ; T3 N0 M0]
  • Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
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  • pTx [Primary tumour cannot be assessed.]
  • pT0 [No evidence of primary tumour.]
  • pTis [Carcinoma in situ.]
  • pT1 [Tumour ≤3cm in greatest dimension and completely surrounded by lung or visceral pleura and not involving a main bronchus.]
  • 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.]
  • 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.]
  • 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.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0008], code=at0008, itemType=ELEMENT, level=2, text=Regional lymph node (pN), description=Pathological assessment of the regional lymph nodes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • pNX [Regional nodes cannot be assessed.]
  • pN0 [No metastasis to regional lymph nodes.]
  • pN1 [Metastasis to ipsilateral intralobar, peribronchial and/or hilar nodes including nodes involved by direct extension of the primary tumour.]
  • pN2 [Metastasis to ipsilateral mediastinal and/or subcarinal nodes.]
  • pN3 [Metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular nodes.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0009], code=at0009, itemType=ELEMENT, level=2, text=Distant metastasis (pM), description=Pathological assessment of distant metastases., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • pMX [Distant metastasis cannot be assessed.]
  • pM0 [No distant metastasis.]
  • pM1 [Distant metastasis present.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006]/items[at0030], code=at0030, itemType=ELEMENT, level=2, text=Residual tumour (pR), description=Pathological assessment of post-treatment residual tumour., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • RX [Presence of residual tumour cannot be assessed. ]
  • RO [No residual tumour.]
  • R1 [Microscopic residual tumour.]
  • R2 [Macroscopic residual tumour.]
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  • GX [Grade of differentiation cannot be assessed.]
  • G1 [Well differentiated.]
  • G2 [Moderately differentiated.]
  • G3 [Poorly differentiated.]
  • G4 [Undifferentiated.]
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  • Stage 0 [Tis N0 M0]
  • Stage IA [T1 N0 M0]
  • Stage IIIB [Any T N3 M0, T4 Any N M0]
  • Stage IB [T2 N0 M0]
  • Stage IIA [T1 N1 M0]
  • Stage IIB [T2 N1 M0 ; T3 N0 M0]
  • Stage IIIA [T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0]
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