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Difference between revisions of "Colorectal cancer staging"
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T3 looks like it is thru... removing
(T3 looks like it is thru... removing) |
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| T4a | | T4a | ||
| invasion of the visceral peritoneum | | invasion of the visceral peritoneum | ||
| | | tumour within 1 mm is ''not'' T4a; however, it should prompt cutting [[deepers]] and taking more sections | ||
|- | |- | ||
| T4b | | T4b | ||
| Line 37: | Line 37: | ||
|} | |} | ||
=== | ===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 | ||
! Criteria | ! Criteria | ||
! Notes | |||
|- | |- | ||
|N0 | |N0 | ||
| no positive nodes | | no positive nodes | ||
| | |||
|- | |- | ||
| N1a | | N1a | ||
| 1 positive node | | 1 positive node | ||
| | |||
|- | |- | ||
| N1b | | N1b | ||
| 2-3 positive nodes | | 2-3 positive nodes | ||
| | |||
|- | |- | ||
| N1c | | N1c | ||
| [[tumour deposit|tumour deposit(s)]] present with all lymph nodes negative | | [[tumour deposit|tumour deposit(s)]] present with all lymph nodes negative | ||
| lesion must be in the drainage bed of the tumour; lesions ''not'' in the drainage bed are M1b | |||
|- | |- | ||
| N2a | | N2a | ||
| 4-6 positive nodes | | 4-6 positive nodes | ||
| | |||
|- | |- | ||
| N2b | | N2b | ||
| 7+ positive nodes | | 7+ positive nodes | ||
| | |||
|} | |} | ||
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> | ||
*Tumour deposits are counted separately. | |||
**Tumour deposits are ''not'' considered lymph nodes. | |||
===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 metastasis|lung]], [[liver metastasis|liver]], ovary or nonregional [[lymph node]] | |||
|- | |||
| M1b | |||
| more than one organ or peritoneal involvement | |||
| [[tumour deposit]]s are in the drainage bed of the tumour - they are not classified as metastases | |||
|} | |||
===Overall stage=== | ===Overall stage=== | ||
| Line 81: | Line 107: | ||
*Stage IIIC - Tx N2. | *Stage IIIC - Tx N2. | ||
*Stage IV - Tx Nx M1. | *Stage IV - Tx Nx M1. | ||
Note: | |||
*[[Tumour perforation in colorectal cancer]] is poor prognosticator;<ref name=pmid17049848>{{Cite journal | last1 = Anwar | first1 = MA. | last2 = D'Souza | first2 = F. | last3 = Coulter | first3 = R. | last4 = Memon | first4 = B. | last5 = Khan | first5 = IM. | last6 = Memon | first6 = MA. | title = Outcome of acutely perforated colorectal cancers: experience of a single district general hospital. | journal = Surg Oncol | volume = 15 | issue = 2 | pages = 91-6 | month = Aug | year = 2006 | doi = 10.1016/j.suronc.2006.09.001 | PMID = 17049848 }}</ref> however, it does ''not'' affect the (overall) stage. It been suggested that perforated colorectal carcinoma be considered stage IV.<ref name=pmid19443386>{{Cite journal | last1 = Ogawa | first1 = M. | last2 = Watanabe | first2 = M. | last3 = Eto | first3 = K. | last4 = Omachi | first4 = T. | last5 = Kosuge | first5 = M. | last6 = Hanyu | first6 = K. | last7 = Noaki | first7 = L. | last8 = Fujita | first8 = T. | last9 = Yanaga | first9 = K. | title = Clinicopathological features of perforated colorectal cancer. | journal = Anticancer Res | volume = 29 | issue = 5 | pages = 1681-4 | month = May | year = 2009 | doi = | PMID = 19443386 }}</ref> | |||
==See also== | ==See also== | ||