What is TNM?
!
TNM is a system for classifying malignant tumours
!
It is a cancer staging system, which describes
the extent of a person's cancer
!
Most types of cancer have TNM designations,
but some do not1
!
Most medical facilities use this system as their
main method for cancer reporting1
1. National Cancer Institute, Cancer Staging, 2010
How does the TNM system work?
The 3 parameters
of the TNM system1:
A number is
added to each letter
to indicate1:
T = extent of the tumour
the size or extent of
N = the extent of spread
the primary tumour
to the lymph nodes
M = presence of distant
the extent of cancer
spread
metastases
1. National Cancer Institute, Cancer Staging, 2010
T = extent of primary tumour
T is classified as follows:1
Tx: Primary tumour cannot be evaluated | T0: No evidence of primary tumour
Tis: Carcinoma in situ (CIS)2 | T1, T2, T3, T4: Size and/or extent of the primary tumour
T0
organ
T1
T2
T3
local tissues
1. National Cancer Institute, Cancer Staging, 2010
2. CIS – abnormal cells are present but have not spread to neighbouring tissue; although not cancer, CIS
may become cancer and is sometimes called pre-invasive cancer
N = extent of spread to lymph nodes
N is classified as follows1:
Nx: Regional lymph nodes cannot be evaluated | N0: No local lymph node involvement
N1: Tumour has spread to local lymph nodes | N2, N3: Involvement of local and distant
lymph nodes (number of lymph nodes and/or extent of spread)
N0
N1
distant
nodes
local nodes
1. National Cancer Institute, Cancer Staging, 2010
N2
M = presence of distant metastases
M is classified as follows1:
Mx: Distant metastasis cannot be evaluated | M0: No distant metastasis
M1: Distant metastasis is present
M0
M1
Mx
?
lung
bone
liver
1. National Cancer Institute, Cancer Staging, 2010