Colorectal carcinoma/staging

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Two classification systems are commonly used to classify colorectal cancer - TNM and Dukes.

TNM classification[1][edit | edit source]

  • T = tumor (Tis = carcinoma in situ, T1 = submucosa, T2 = muscularis propria, T3 = subserosa, pericolic or perirectal tissues, T4a = visceral peritoneum, T4b = other organs or structures)
  • N = regional lymph node involvement (N0 = no LN involvement, N1a = 1 regional lymph node, N1b = 2-3 regional lymph nodes, N1c = satellites without regional lymph nodes, N2a = 4-6 regional LNs, N2b = 7 or more regional LNs, Nx = undetected number of affected lymph nodes - less than 12 LNs from bowel resection examined)
  • M = distant metastases (M0 = no distant metastases, M1a = 1 organ, M1b = more than 1 organ, peritoneum)
Stage T N M
Stage 0 Tis N0 M0
Stage I T1, T2 N0 M0
Stage IIa T3 N0 M0
Stage IIb T4a N0 M0
Stage IIc T4b N0 M0
Stage IIIa T1, T2 N1 M0
T1 N2a M0
Stage IIIb T3, T4a N1 M0
T2,T3 N2a M0
T1, T2 N2b M0
Stage IIIc T4a N2a M0
T3, T4a N2b M0
T4b N1, N2 M0
Stage IVa any T any N M1a
Stage IVb any T any N M1b

Duke's classification [2][edit | edit source]

Stádium Description
Stage A tumour confined by the intestinal wall
Stage B the tumour invades or penetrates the serosa
Stage C1 tumour + positive pericolic lymph nodes
Stage C2 tumour + positive perivascular nodes
Stage D distant metastases


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References[edit | edit source]

  1. SOBIN, L. H. TNM klasifikace zhoubných novotvarů. 7. edition. Praha : Ústav zdravotnických informací a statistiky České republiky, 2011. pp. 88-92. ISBN 978-80-904259-6-5.
  2. ZEMAN, Miroslav, et al. Speciální chirurgie. 2. edition. Praha : Galén, 2006. 575 pp. pp. 300. ISBN 80-7262-260-9.