Clinical M

This input is used for staging

Notes

**Note:** Most pleural and pericardial effusions with lung cancer are due to tumor. In a few patients, however, multiple cytopathologic examinations of pleural and/or pericardial fluid are negative for tumor, and the fluid is nonbloody and is not an exudate. * Where these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging element and the tumor should be classified as M0 **Distant lymph nodes** Cervical

NAACCR Item

NAACCR #960
Clinical M Clinical M Display Description Registrar Notes
c0 cM0 No distant metastasis Unknown; distant metastasis not stated
Distant metastasis cannot be assessed
Not documented in patient record
c1 cM1 Distant metastasis CLINICAL assessment only:
Note: M1 has subcategories of M1a and M1b. Assign M1 only when there is no information available to assign one of the subcategories

Distant metastasis, NOS

Stated as M1 [NOS]
c1A cM1a Separate tumor nodule(s) in a contralateral lobe; tumor with pleural nodules OR malignant pleural or pericardial effusion CLINICAL assessment only:
Extension to:
Contralateral lung
Contralateral main stem bronchus

Malignant pericardial or pleural effusion (Ipsilateral, contralateral or bilateral lung) (see Note)
Pleural tumor foci or nodules on contralateral lung
Pleural tumor foci or nodules on the ipsilateral lung separate from direct invasion
Separate tumor nodule(s) in contralateral lung

Stated as M1a
c1B cM1b Distant metastasis CLINICAL assessment only:
Distant lymph nodes, NOS

Distant metastasis:
Abdominal organs

Extension to:
Skeletal muscle
Sternum
Skin of chest
Separate lesion in chest wall or diaphragm

Other distant metastasis plus any distant metastasis specified in M1a

Carcinomatosis

Distant metastases WITH or WITHOUT distant lymph nodes

Stated as M1b
p1 pM1 Distant metastasis HISTOLOGICALLY confirmed:
Note: M1 has subcategories of M1a and M1b. Assign M1 only when there is no information available to assign one of the subcategories

Distant metastasis, NOS
p1A pM1a Separate tumor nodule(s) in a contralateral lobe; tumor with pleural nodules OR malignant pleural or pericardial effusion HISTOLOGICALLY confirmed:
Extension to:
Contralateral lung
Contralateral main stem bronchus

Malignant pericardial or pleural effusion (Ipsilateral, contralateral or bilateral lung) (see Note)
Pleural tumor foci or nodules on contralateral lung
Pleural tumor foci or nodules on the ipsilateral lung separate from direct invasion
Separate tumor nodule(s) in contralateral lung
p1B pM1b Distant metastasis HISTOLOGICALLY confirmed:
Distant lymph nodes, NOS

Distant metastasis:
Abdominal organs

Extension to:
Skeletal muscle
Sternum
Skin of chest
Separate lesion in chest wall or diaphragm

Other distant metastasis plus any distant metastasis specified in M1a

Carcinomatosis

Distant metastases WITH or WITHOUT distant lymph nodes

Distant metastasis, NOS
88 88 Not applicable Primary site/histology not TNM defined
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Clinical classification criteria not met
Clinical classification criteria met, evaluation done:
No information about diagnostic workup
Results not documented in patient record
Clinical evaluation of T and N not done, no evidence metastatic disease
Tumor first detected on surgical resection (no clinical workup)
Only Clinical Stage Group documented (no T, N, or M information available)