Colorectal cancer staging: Difference between revisions
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===Dukes Classification System=== | ===Dukes Classification System=== | ||
Dukes classification | Dukes classification was first proposed by Dr Cuthbert E. Dukes in 1932.<ref>Dukes CE. The classification of cancer of the rectum. ''Journal of Pathological Bacteriology'' 1932;35:323.</ref> | ||
The following table describes the Duke's classification stages: | |||
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Revision as of 18:58, 16 July 2015
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Colorectal cancer Microchapters |
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Colorectal cancer staging On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.; Elliot B. Tapper, 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 optimal method of treatment. Staging is based on the TNM classification system which depends 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 was first proposed by Dr Cuthbert E. Dukes in 1932.[1]
The following table describes the Duke's classification stages:
| Stage | Description |
| A | Tumor confined to the intestinal wall |
| B | Tumor 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.