Colorectal cancer staging: Difference between revisions
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==Grades of Colorectal Cancer== | ===Grades of Colorectal Cancer=== | ||
The grade describes how closely the cancer looks like normal tissue when seen under a microscope. This is sometimes used to distinguish whether a patient should get adjuvant treatment with chemotherapy after surgery. | The grade describes how closely the cancer looks like normal tissue when seen under a microscope. This is sometimes used to distinguish whether a patient should get adjuvant treatment with chemotherapy after surgery. | ||
*Grade 1 - Well differentiated | *Grade 1 - Well differentiated |
Revision as of 17:46, 14 July 2015
Template:Colorectal cancer
To view the staging of familial adenomatous polyposis (FAP), click here
To view the staging of hereditary nonpolyposis colorectal cancer (HNPCC), click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Elliot B. Tapper, M.D., Saarah T. Alkhairy, M.D.
Overview
Colorectal cancer staging is an estimate of the amount of penetration of the cancer. It is performed for diagnostic and research purposes, and to determine the best method of treatment. The systems for staging colorectal cancers largely depend on the extent of local invasion, the degree of lymph node involvement, and whether there is distant metastasis. The staging systems are called Duke's classification, TMN classification, and AJCC stage grouping.
Colorectal Cancer Staging
Colorectal cancer staging is an estimate of the amount of penetration of the cancer. It is performed for diagnostic and research purposes, and to determine the best method of treatment. The systems for staging colorectal cancers largely depend on the extent of local invasion, the degree of lymph node involvement, and whether there is distant metastasis.
Definitive staging can only be done after surgery has been performed and pathology reports have been reviewed. An exception to this principle would be after a colonoscopic polypectomy of a malignant pedunculated polyp with minimal invasion. Preoperative staging of rectal cancers may be done with endoscopic ultrasound. Adjuncts to staging of metastasis include abdominal ultrasound, CT, PET scanning, and other imaging studies.
Dukes Classification System
Dukes classification, first proposed by Dr Cuthbert E. Dukes in 1932, identifies the stages as:[1]
- A - Tumour confined to the intestinal wall
- B - Tumour invading through the intestinal wall
- C - With lymph node(s) involvement
- D - With distant metastasis
TNM Classification System
The most common current staging system is the TNM classification (tumors/nodes/metastases) system, though many doctors still use the older Dukes system. The TNM classification system assigns a number[2].
The table below displays which TNM values represent which stage.
Stage | TNM Value |
0 | Tis, N0, M0 |
I | T1, N0, M0; T2, N0, M0 |
IIA | T3, N0, M0 |
IIB | T4, N0, M0 |
IIIA | T1, N1, M0; T2, N1, M0 |
IIIB | T3, N1, M0; T4, N1, M0 |
IIIC | Any T, N2, M0 |
IV | Any T, Any N, M1 |
Grades of Colorectal Cancer
The grade describes how closely the cancer looks like normal tissue when seen under a microscope. This is sometimes used to distinguish whether a patient should get adjuvant treatment with chemotherapy after surgery.
- Grade 1 - Well differentiated
- Grade 2 - Moderately differentiated
- Grade 3 - Poorly differentiated
- Grade 4 - Undifferentiated
References
- ↑ Dukes CE. The classification of cancer of the rectum. Journal of Pathological Bacteriology 1932;35:323.
- ↑ Wittekind, Ch; Sobin, L. H. (2002). TNM classification of malignant tumours. New York: Wiley-Liss. ISBN 0-471-22288-7.