THE TNM CLASSIFICATION

The TNM classification was adopted as a means of evaluating bronchopul monary cancer and has been used since 1996 It is an international clas sification and has been recognised since 1986 [5]. After a brief revie w of the former TNM classification the different features of the newly defined classification are specified concerning particularly the defi nition of T-3 and T-4 tumours, some malignant T-4 pleural effusions an d disease of the lymph nodes (N-2, N-3) as well as a final classificat ion with 5 stages. Some controversy has appeared over the daily use of this classification and are discussed in the recent literature. They are related to: the re-grouping in Stage 1 of patients with different survivals (T1N0M0 and T2N0M0), the resectability of cei tain T-4 tumou rs involving the carina, the adverse prognosis of invasion of the visc eral pleural and above all the definition of N-2 mediastinal node dise ase which groups together patients with a very heterogeneous prognosis . In 1993, a supplement was publisched by the International Union Agai nst Cancer (UICC) entitled ''Commentary on the Uniform Use of TNM''. T he commentaries referred to the bronchopulmonary cancers that have bee n re-grouped and included point by point discussion of the TNM classif ication. Very recently, Moutain has published some revisions of the TN M classification which will be discussed here.