Stage IIIB Lung Cancer AJCC v9

**Semantic type:** Neoplastic Process

**Definition:** Stage IIIB includes: (T2, N2b, M0); (T3, N2b, M0); (T4, N2a, M0); (T4, N2b, M0); (T1, N3, M0); (T2, N3, M0). T2: Tumor measuring more than 3 cm but 5 cm or less in greatest dimension or tumor measuring 4 cm or less with one or more of the following features: invasion of visceral pleura; invasion of an adjacent lobe; involvement of main bronchus (up to but not including the carina) or association with atelectasis or obstructive pneumonitis, extending to the hilar regions, involving either part of or the entire lung. T3: Tumor measuring more than 5 cm but 7 cm or less in greatest dimension or tumor measuring 7 cm or less with one or more of the following features: invasion of parietal pleura or chest wall; invasion of pericardium, phrenic nerve or azygos vein (although these structures lie within the mediastinum, the degree of mediastinal penetration by the tumor needed to invade these structures is not counted as T4); invasion of thoracic nerve roots (i.e., T1, T2) or stellate ganglion; presence of separate tumor nodule(s) in the same lobe as the primary. T4: Tumor measuring more than 7 cm in greatest dimension or tumor of any size with one or more of the following features: invasion of mediastinum (except structures listed in T3), thymus, trachea, carina, recurrent laryngeal nerve, vagus nerve, esophagus or diaphragm; invasion of heart, great vessels (aorta, superior/inferior vena cava, intrapericardial pulmonary arteries/veins), supra-aortic arteries or brachiocephalic veins; invasion of subclavian vessels, vertebral body, lamina, spinal canal, cervical nerve roots or brachial plexus (i.e., trunks, divisions, cords or terminal nerves); presence of separate tumor nodule(s) in a different ipsilateral lobe than that of the primary. T1: Tumor measuring 3 cm or less in greatest dimension surrounded by lung or visceral pleura, or in a lobar or more peripheral bronchus. N2b: Tumor involvement of multiple ipsilateral mediastinal nodal stations with or without involvement of the subcarinal nodal station. N2a: Tumor involvement of a single ipsilateral mediastinal nodal station or of the subcarinal nodal station. N3: Tumor involvement of contralateral mediastinal, contralateral hilar, ipsilateral/contralateral scalene, or ipsilateral/contralateral supraclavicular lymph node station(s). M0: No distant metastasis. (AJCC 9th ed.)