Difference between revisions of "Colorectal cancer staging"

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===Nodal stage===
===Nodal stage===
Nodal stage as per AJCC 7th edition:<ref name=Ref_AJCC7HB198>{{Ref AJCC7HB|198}}</ref>
{| class="wikitable sortable"  
{| class="wikitable sortable"  
! Stage
! Stage
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Notes:
Notes:
*Memory device for N2 = 4+ positive LNs: the number ''four'' in chinese sounds like ''death''.<ref>URL: [http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four]. Accessed on: 28 June 2011.</ref>
*Memory device for N2 = 4+ positive LNs: the number ''four'' in chinese sounds like ''death''.<ref>URL: [http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four]. Accessed on: 28 June 2011.</ref>
===Metastasis stage===
Metastasis stage as per AJCC 7th edition:<ref name=Ref_AJCC7HB198>{{Ref AJCC7HB|198}}</ref>
{| class="wikitable sortable"
! Stage
! Criteria
! Notes
|-
| M1a
| One organ only
| lung liver, ovary or nonregional [[lymph node]]
|-
| M1b
| more than one organ or peritoneal involvement
|
|}


===Overall stage===
===Overall stage===

Revision as of 20:32, 31 May 2016

This article deals with colorectal cancer staging.

General

TNM staging is very widely used. There is also the Dukes' system, which in many respects is quite similar.[1]

TNM staging system

Tumour stage

Stage Criteria Notes
Tis in situ (intramucosal) ‡ high-grade dysplasia, "intramucosal colorectal carcinoma", and "colorectal adenocarcinoma in situ" are used interchangeably by many in the colon and rectum; high-grade dysplasia is the preferred term - see "intramucosal colorectal carcinoma"
T1 into submucosa (through mucularis mucosae), not into muscularis propria different than elsewhere in GI tract; in the small bowel tumour cells in the lamina propria is defined as T1; rationale for the T1 definition in CRC is that no lymphatics are present in the mucosa, ergo no risk of distant spread
T2 into muscularis propria
T3 into fat beyond musclaris propria
T4a invasion of the visceral peritoneum
T4b grows into something else

Nodal stage

Nodal stage as per AJCC 7th edition:[2]

Stage Criteria
N0 no positive nodes
N1a 1 positive node
N1b 2-3 positive nodes
N1c tumour deposit(s) present with all lymph nodes negative
N2a 4-6 positive nodes
N2b 7+ positive nodes

Notes:

  • Memory device for N2 = 4+ positive LNs: the number four in chinese sounds like death.[3]

Metastasis stage

Metastasis stage as per AJCC 7th edition:[2]

Stage Criteria Notes
M1a One organ only lung liver, ovary or nonregional lymph node
M1b more than one organ or peritoneal involvement

Overall stage

Simple version

Tumour/node grade for stage:[4]

  • Stage I - T1 or T2 N0 M0.
  • Stage II - T3 or T4 N0 M0.
  • Stage III - Tx N1 or N2 M0.
  • Stage IV - Tx Nx M1.

Complex version

Detailed tumour/node grade for stage:[5]

  • Stage I - T1 or T2.
  • Stage IIA - T3.
  • Stage IIB - T4.
  • Stage IIIA - T1 N1 or T2 N1.
  • Stage IIIB - T3 N1 or T4 N1.
  • Stage IIIC - Tx N2.
  • Stage IV - Tx Nx M1.

See also

References

  1. URL: http://www.cancerresearchuk.org/about-cancer/type/bowel-cancer/treatment/dukes-stages-of-bowel-cancer. Accessed on: 12 January 2016.
  2. 2.0 2.1 American Joint Committee on Cancer (2010). AJCC Cancer Staging Handbook: From the AJCC Cancer Staging Manual (7th ed.). New York: Springer. pp. 198. ISBN 978-0387884424.
  3. URL: http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four. Accessed on: 28 June 2011.
  4. Shiau, Carolyn; Toren, Andrew (2006). Toronto Notes 2006: Comprehensive Medical Reference (Review for MCCQE 1 and USMLE Step 2) (22nd edition (2006) ed.). Toronto Notes for Medical Students, Inc.. pp. GS27. ISBN 978-0968592861.
  5. http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp