Cancer staging systems

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Schematic showing the T stages in bladder cancer. (WC/CRUK)

Cancer staging systems are used to prognosticate cancer and determine treatment. They classify cancers based on the extent of tumour or the location of the tumour in relation to where it arose.




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.


Table of modifiers:[4]

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

Metastasis stage

See also


  1. Bruins, HM.; Visser, O.; Ploeg, M.; Hulsbergen-van de Kaa, CA.; Kiemeney, LA.; Witjes, JA. (Oct 2012). "The clinical epidemiology of urachal carcinoma: results of a large, population based study.". J Urol 188 (4): 1102-7. doi:10.1016/j.juro.2012.06.020. PMID 22901574.
  2. Mori, T.; Nomori, H.; Ikeda, K.; Yoshioka, M.; Kobayashi, H.; Iwatani, K.; Yoshimoto, K.; Iyama, K. (Feb 2007). "Three cases of multiple thymoma with a review of the literature.". Jpn J Clin Oncol 37 (2): 146-9. doi:10.1093/jjco/hyl147. PMID 17337514.
  3. Koga, K.; Matsuno, Y.; Noguchi, M.; Mukai, K.; Asamura, H.; Goya, T.; Shimosato, Y. (May 1994). "A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma.". Pathol Int 44 (5): 359-67. PMID 8044305.
  4. URL: Accessed on: 28 March 2012.
  5. URL: Accessed on: 6 April 2012.

External links