- no distant metastasis present.
- distant metastasis present.
- distant metastasis cannot be evaluated.
- metastasis present only in immediate lymph nodes.
Number 1 is correct.
Rationale: M0 refers to no distant metastasis being present; the cancer has not spread to the lymph nodes or other parts of the body. M1-4 indicates ascending degrees of metastatic involvement, including distant nodes. MX means metastasis cannot be evaluated.