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 |