Stomach cancer staging: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{CMG}}{{AE}}{{PSD}}
{{CMG}}{{AE}}{{PSD}}
{{Stomach cancer}}
{{Stomach cancer}}
Line 10: Line 11:
The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer
The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer
===Definitions of TNM===
===Definitions of TNM===
====Primary tumor====
*TX: [[Primary tumor]] cannot be assessed
*T0: No evidence of [[primary tumor]]
*Tis: Carcinoma in situ: intraepithelial [[tumor]] without invasion of the [[lamina propria]]
*T1: [[Tumor]] invades [[lamina propria]], [[muscularis mucosae]], or [[submucosa]]
*T1a: [Tumor]] invades [[lamina propria]] or [[muscularis mucosae]]
*T1b: [[Tumor]] invades [[submucosa]]
*T2: [[Tumor]] invades [[muscularis propria]]
*T3: [[Tumor]] penetrates subserosal [[connective tissue]] without invasion of [[visceral peritoneum]] or adjacent structures
*T4: [[Tumor]] invades [[serosa]] (visceral peritoneum) or adjacent structures
*T4a: [[Tumor]] invades [[serosa]] (visceral peritoneum)
*T4b: [[Tumor]] invades adjacent structures
====Regional Lymph Nodes====
*NX: Regional [[lymph node]](s) cannot be assessed
*N0: No regional [[lymph node]] [[metastasis]]
*N1: Metastases in 1–2 regional [[lymph nodes]]
*N2: Metastases in 3–6 regional [[lymph nodes]]
*N3: Metastases in ≥7 regional [[lymph nodes]]
*N3a: Metastases in 7–15 regional [[lymph nodes]]
*N3b: Metastases in ≥16 regional [[lymph nodes]]
====Distant Metastasis====
*M0: No distant [[metastasis]]
*M1: Distant [[metastasis]]
===AJCC Stage Groupings===
====Stage 0====
*Tis, N0, M0
====Stage IA====
*T1, N0, M0
====Stage IB====
*T2, N0, M0
*T1, N1, M0
====Stage IIA====
*T3, N0, M0
*T2, N1, M0
*T1, N2, M0
====Stage IIB====
*T4a, N0, M0
*T3, N1, M0
*T2, N2, M0
*T1, N3, M0
====Stage IIIA====
*T4a, N1, M0
*T3, N2, M0
*T2, N3, M0
====Stage IIIB====
*T4b, N0, M0
*T4b, N1, M0
*T4a, N2, M0
*T3, N3, M0
====Stage IIIC====
*T4b, N2, M0
*T4b, N3, M0
*T4a, N3, M0
====Stage IV====
*Any T, Any N, M1 <ref>http://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#section/_17</ref>
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Adrenal cancer TNM staging'''''
|+'''''Stomach cancer TNM staging'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
|-
|-
! style="background: #DCDCDC;" |TX
! style="background: #DCDCDC;" |TX
! style="background: #F5F5F5;" |Primary [[tumor]] cannot be assessed
! style="background: #F5F5F5;" |[[Primary tumor]] cannot be assessed
|-
!Tis
!Carcinoma in situ: intraepithelial [[tumor]] without invasion of the [[lamina propria]]
|-
|-
! style="background: #DCDCDC;" |T0
! style="background: #DCDCDC;" |T0
Line 123: Line 26:
|-
|-
! style="background: #DCDCDC;" |T1
! style="background: #DCDCDC;" |T1
! style="background: #F5F5F5;" |[[Tumor]] ≤5 cm in greatest dimension limited to the [[thyroid|adrenals]]
! style="background: #F5F5F5;" |[[Tumor]] invades [[lamina propria]], [[muscularis mucosae]], or [[submucosa]]
T1a: Tumor invades [[lamina propria]] or [[muscularis mucosae]]
 
T1b: [[Tumor]] invades [[submucosa]]
|-
|-
! style="background: #DCDCDC;" |T2
! style="background: #DCDCDC;" |T2
! style="background: #F5F5F5;" |[[Tumor]] >5 cm in greatest dimension, limited to the adrenals
! style="background: #F5F5F5;" |[[Tumor]] invades [[muscularis propria]]
|-
|-
! style="background: #DCDCDC;" |T3
! style="background: #DCDCDC;" |T3
! style="background: #F5F5F5;" |Tumor of any size with local invasion, but not invading adjacent organs
! style="background: #F5F5F5;" |[[Tumor]] penetrates subserosal [[connective tissue]] without invasion of [[visceral peritoneum|visceral peritoneum or adjacent structures]]
|-
|-
! style="background: #DCDCDC;" |T4
! style="background: #DCDCDC;" |T4
! style="background: #F5F5F5;" |Tumor of any size with invasion of adjacent organs
! style="background: #F5F5F5;" |T4: [[Tumor]] invades [[serosa]] (visceral peritoneum) or adjacent structures
 
T4a: [[Tumor]] invades [[serosa]] (visceral peritoneum)
 
T4b: [[Tumor]] invades adjacent structures
|}
|}


Line 147: Line 57:
|-
|-
! style="background: #DCDCDC;" |N1
! style="background: #DCDCDC;" |N1
! style="background: #F5F5F5;" |Regional [[lymph node]] metastasis
! style="background: #F5F5F5;" |Metastasis in 1-2 regional lymph nodes
|-
!N2
!Metastasis in 3-6 regional lymph nodes
|-
!N3
!Metastasis in seven or more regional lymph nodes
N3a: Metastasis in 7-15 regional lymph nodes
 
N3b: Metastasis in 16 or more regional lymph nodes
|}
|}


Line 164: Line 83:
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Anatomic Stage/Prognostic Groups'''''
|+'''''Anatomic Stage/Prognostic Groups'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! colspan="2" style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|T}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|T}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|N}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|N}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
|-
|-
! style="background: #DCDCDC;" |I
! colspan="2" |
! style="background: #F5F5F5;" |T1
====Stage 0====
 
!Tis
! style="background: #F5F5F5;" |N0
!N0
 
!M0
! style="background: #F5F5F5;" |M0
|-
! rowspan="3" |I
!Stage IA
!T1
!N0
!M0
|-
! rowspan="2" |Stage IB
!T2
!N0
!M0
|-
!T1
!N1
!M0
|-
! rowspan="6" |II
! rowspan="3" |Stage IIA
!T3
!N0
!M0
|-
!T2
!N1
!M0
|-
!T1
!N2
!M0
|-
! rowspan="3" |Stage IIB
!T4a
!N0
!M0
|-
!T3
!N1
!M0
|-
|-
! style="background: #DCDCDC;" |II
!T2
! style="background: #F5F5F5;" |T2
!N2
 
!M0
! style="background: #F5F5F5;" |N0
 
! style="background: #F5F5F5;" |M0
|-
|-


! style="background: #DCDCDC;" |III
! rowspan="8" style="background: #DCDCDC;" |III
!Stage IIIA
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |N1
Line 190: Line 144:


|-
|-
 
! rowspan="4" |Stage IIIB
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T4b
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |M0
|-
|-
 
!T4b
! style="background: #DCDCDC;" |
!N1
! style="background: #F5F5F5;" |T3
!M0
! style="background: #F5F5F5;" |N0
|-
! style="background: #F5F5F5;" |M0
!T4a
 
!N2
!M0
|-
!T3
!N3
!M0
|-
|-
 
! rowspan="3" |Stage IIIC
! style="background: #DCDCDC;" |IV
!T4b
! style="background: #F5F5F5;" |T3
!N2
! style="background: #F5F5F5;" |N1
!M0
! style="background: #F5F5F5;" |M0
|-
|-
!
!T4b
!T4
!N3
!N0
!M0
!M0
|-
|-
!
!T4a
!T4
!N3
!N1
!M0
!M0
|-
|-
!IV
!
!
!Any T
!Any T

Revision as of 15:41, 1 November 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Stomach cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Stomach Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Endoscopy and Biopsy

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Stomach cancer staging On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Stomach cancer staging

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Stomach cancer staging

CDC on Stomach cancer staging

Stomach cancer staging in the news

Blogs on Stomach cancer staging

Directions to Hospitals Treating Stomach cancer

Risk calculators and risk factors for Stomach cancer staging

Overview

According to the American Joint Committee on Cancer, there are 4 stages of stomach cancer based on the tumor spread.

Staging

The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer

Definitions of TNM

Stomach cancer TNM staging
Stage Description
TX Primary tumor cannot be assessed
Tis Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria
T0 No evidence of primary tumor
T1 Tumor invades lamina propria, muscularis mucosae, or submucosa

T1a: Tumor invades lamina propria or muscularis mucosae

T1b: Tumor invades submucosa

T2 Tumor invades muscularis propria
T3 Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures
T4 T4: Tumor invades serosa (visceral peritoneum) or adjacent structures

T4a: Tumor invades serosa (visceral peritoneum)

T4b: Tumor invades adjacent structures

Regional Lymph Nodes (N)
Stage Description
NX Regional lymph node cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in 1-2 regional lymph nodes
N2 Metastasis in 3-6 regional lymph nodes
N3 Metastasis in seven or more regional lymph nodes

N3a: Metastasis in 7-15 regional lymph nodes

N3b: Metastasis in 16 or more regional lymph nodes

Distant Metastasis (M)
Stage Description
M0 No distant metastasis
M1 Distant metastasis
Anatomic Stage/Prognostic Groups
Stage T N M

Stage 0

 Tis N0 M0
I Stage IA T1 N0 M0
Stage IB T2 N0 M0
T1 N1 M0
II Stage IIA T3 N0 M0
T2 N1 M0
T1 N2 M0
Stage IIB T4a N0 M0
T3 N1 M0
T2 N2 M0
III Stage IIIA T1 N1 M0
Stage IIIB T4b N0 M0
T4b N1 M0
T4a N2 M0
T3 N3 M0
Stage IIIC T4b N2 M0
T4b N3 M0
T4a N3 M0
IV Any T Any N M1

References

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Stomach_cancer_staging&oldid=1382477"