Difference between revisions of "Cancer staging systems"

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'''Cancer staging systems''' are something pathologists ought to be familiar with.
'''Cancer staging systems''' are something pathologists ought to be familiar with. They classify cancers based on the extent of tumour or the location of the tumour in relation to where it arose.


=Overview=
=Overview=

Revision as of 19:32, 2 February 2013

Cancer staging systems are something pathologists ought to be familiar with. They classify cancers based on the extent of tumour or the location of the tumour in relation to where it arose.

Overview

Systems

Stage

Most system are four tiered and use Roman numerals to denote the stage:

  • Stage I: early cancer.
  • Stage II: late early cancer (cancer between early and advanced stage).
  • Stage III: advanced cancer - often defined by lymph node metastasis.
  • Stage IV: late advanced cancer - often defined by metastasis.

TNM staging system

  • Name of the system comes from the elements: Tumour, Nodes (lymph nodes), Metastasis (distant).
  • Most common staging system.
  • Staging parameters dependent on the specific site.

Modifiers

Table of modifiers:[1]

Modifier Meaning Example Notes
m multiple tumours pT(m)NM or pT2(2)N0Mx tumour stage = highest stage of all the individual tumours
c clinical stage cTNM if it is not specified clinical is assumed
p pathologic stage pTNM derived from a surgical specimen or biopsy
a stage at autopsy aTNM malignancy was not staged previously or treated - unless otherwise specified
y staging after therapy ypTNM do not try to estimate pretreatment stage
r recurrent tumour stage rTNM must have a clinically documented disease freedom

Tumour stage

Usually determined by one of the following:

  1. Size of the tumour (maximal dimension).
  2. Depth of invasion.

Other factors:

Nodal stage

  • Lymph node involvement.
  • Positive lymph nodes (without mets) often upstage to stage III.
    • May upstage to stage II in some tumours.
  • Sampling may be selective (sentinel lymph nodes).

Metastasis stage

See also

References