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It is crucial for patient stratification, treatment planning, and survival prognosis. Clinical staging (cTNM) relies on imaging and physical exams, while pathological staging (pTNM) uses surgical specimens. Advances in tumour biology, imaging, surgery, and treatments necessitate periodic updates to ensure the system reflects current knowledge and practices effectively. The International Association for the Study of Lung Cancer (IASLC), alongside the American Joint Committee on Cancer (AJCC) and Union for International Cancer Control (UICC), updates the system through a global, multidisciplinary approach supported by international data and statistical analysis. The ninth edition of the TNM classification, effective January 1, 2025, introduces revisions to the N and M categories while the T categories remain identical. N2 (ipsilateral mediastinal nodal disease) is now divided into N2a (single lymph node station involvement) and N2b (multiple N2 stations involvement). Similarly, M1c category is split into M1c1 (metastases confined to 1 organ system) and M1c2 (metastases involving multiple organ systems). These updates aim to improve the accuracy and utility of lung cancer staging in clinical practice and research.<\/jats:p>","DOI":"10.1093\/bjr\/tqaf161","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T15:47:52Z","timestamp":1752594472000},"page":"1543-1555","source":"Crossref","is-referenced-by-count":2,"title":["Something old something new\u2014introduction to the ninth edition TNM classification of lung cancer"],"prefix":"10.1093","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-4303","authenticated-orcid":false,"given":"Daria","family":"Kifjak","sequence":"first","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna , 1090 Vienna,","place":["Austria"]},{"name":"Christian Doppler Laboratory for Machine Learning Driven Precision Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna , 1090 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