A 56 year-old woman presents with a 2.1 cm right upper lobe adenocarcinoma and a 1.9 cm right lower lobe adenocarcinoma. What is this patient's AJCC 8th edition T classification?
Per the AJCC Cancer Staging Manual, 8th edition, separate tumor nodules in different ipsilateral lobes are classified as T4. Separate tumor nodules are T3 if within the same lobe and M1a if within the contralateral lung.
The updated AJCC 8th edition staging system includes changes from the 7th edition. T classification has the most significant changes:
Nodal classification is unchanged. Metastasis now includes "M1b" which is a single extrathoracic metastasis in a single organ (including involvement of a single nonregional node).
Stage groups now include IA1, IA2, and IA3 based on T1a, T1b, and T1c, respectively. Stage IIIC is a new group that includes T3-4 N3 disease. Other N2 and N3 tumors now span stage groups IIIA and IIIB based on T1-2 or T3-4 classification.
Regional Lymph Nodes