Difference between revisions of "Colorectal cancer staging"
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==TNM staging system== | ==TNM staging system== | ||
===Tumour stage=== | ===Tumour stage=== | ||
{| class="wikitable sortable" | |||
! Stage | |||
! Criteria | |||
! Notes | |||
|- | |||
| Tis | |||
| in situ ([[Intramucosal colorectal carcinoma|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 | |||
| | |||
|} | |||
===Nodes stage=== | ===Nodes stage=== | ||
Revision as of 20:10, 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 |
Nodes stage
- N0 - no positive nodes.
- N1 - 1-3 positive nodes.
- N2 - 4+ positive nodes.
- N2a - 4-6 positive nodes.
- N2b - 7+ positive nodes.
Notes:
- Memory device for N2 = 4+ +ve LNs: the number four in chinese sounds like death.[2]
Overall stage
Simple version
Tumour/node grade for stage:[3]
- 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:[4]
- 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
- ↑ URL: http://www.cancerresearchuk.org/about-cancer/type/bowel-cancer/treatment/dukes-stages-of-bowel-cancer. Accessed on: 12 January 2016.
- ↑ URL: http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four. Accessed on: 28 June 2011.
- ↑ 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.
- ↑ http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp