Adrenocortical carcinoma staging: Difference between revisions

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__NOTOC__
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{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}} {{AE}} {{AAM}}
{{CMG}}; {{AE}} {{AAM}} {{MAD}}
==Overview==
==Overview==
According to the [[TNM staging system]], there are four stages of adrenocortical cancer based on the [[tumor]] size, [[lymph nodes]], and distant [[metastasis]]. Each stage is assigned a number and letter that designates the number of lymph nodes involved and presence/absence of distant metastasis.
According to the [[TNM staging system]], there are four stages of adrenocortical cancer based on the [[tumor]] size, [[lymph nodes]], and distant [[metastasis]]. Each stage is assigned a number and letter that designates the number of [[lymph nodes]] involved and presence/absence of [[Metastasis|distant metastasis]].


==Staging of adrenocortical carcinoma==
==Staging of adrenocortical carcinoma==
The AJCC has designated staging by TNM to define adrenocortical carcinoma<ref name=AJCC Cancer Staging Manual>Adrenal. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 516-7</ref>
The AJCC has designated staging by [[TNM Staging System|TNM]] to define adrenocortical carcinoma: <ref name="pmid20180029">{{cite journal| author=Edge SB, Compton CC| title=The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. | journal=Ann Surg Oncol | year= 2010 | volume= 17 | issue= 6 | pages= 1471-4 | pmid=20180029 | doi=10.1245/s10434-010-0985-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20180029  }}</ref>
===Staging according to TNM staging system===
 
{|{{table}}
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
| Stage
|+'''''Adrenal cancer TNM staging'''''
| T
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
| N
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
| M
|-
|-
| I||T1||N0||M0
! style="background: #DCDCDC;" |TX
! style="background: #F5F5F5;" |Primary [[tumor]] cannot be assessed
|-
|-
| II||T2||N0||M0
! style="background: #DCDCDC;" |T0
! style="background: #F5F5F5;" |No evidence of primary [[tumor]]
|-
|-
| III||T1||N1||M0
! style="background: #DCDCDC;" |T1
! style="background: #F5F5F5;" |[[Tumor]] ≤5 cm in greatest dimension limited to the [[thyroid|adrenals]]
|-
|-
| ||T2||N1||M0
! style="background: #DCDCDC;" |T2
! style="background: #F5F5F5;" |[[Tumor]] >5 cm in greatest dimension, limited to the adrenals
|-
|-
| ||T3||N0||M0
! style="background: #DCDCDC;" |T3
! style="background: #F5F5F5;" |Tumor of any size with local invasion, but not invading adjacent organs
|-
|-
| IV||T3||N1||M0
! style="background: #DCDCDC;" |T4
! style="background: #F5F5F5;" |Tumor of any size with invasion of adjacent organs
|}
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Regional Lymph Nodes (N)'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
|-
|-
| ||T4||N0||M0
! style="background: #DCDCDC;" |NX
! style="background: #F5F5F5;" |Regional [[lymph node]] cannot be assessed
|-
|-
| ||T4||N1||M0
! style="background: #DCDCDC;" |N0
|-
! style="background: #F5F5F5;" |No regional lymph node metastasis
| ||Any T||Any N||M1
|-
|-
! style="background: #DCDCDC;" |N1
! style="background: #F5F5F5;" |Regional [[lymph node]] metastasis
|}
|}


===Tumor size (T)===
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
{| {{table}}
|+'''''Distant Metastasis (M)'''''
 
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
| TX
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Description}}
| Primary tumor cannot be assessed.
|-
|-
| T0||No evidence of primary tumor.
! style="background: #DCDCDC;" |M0
! style="background: #F5F5F5;" |No distant [[metastasis]]
|-
|-
| T1||Tumor ≤5 cm in greatest dimension, no extra-adrenal invasion.
! style="background: #DCDCDC;" |M1
! style="background: #F5F5F5;" |Distant [[metastasis]]
|}
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Anatomic Stage/Prognostic Groups'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|T}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|N}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
|-
|-
| T2||Tumor >5 cm, no extra-adrenal invasion.
! style="background: #DCDCDC;" |I
! style="background: #F5F5F5;" |T1
 
! style="background: #F5F5F5;" |N0
 
! style="background: #F5F5F5;" |M0
|-
|-
| T3||Tumor of any size with local invasion, but not invading adjacent organs.
! style="background: #DCDCDC;" |II
! style="background: #F5F5F5;" |T2
 
! style="background: #F5F5F5;" |N0
 
! style="background: #F5F5F5;" |M0
|-
|-
| T4||Tumor of any size with invasion of adjacent organs.
 
! style="background: #DCDCDC;" |III
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0
 
|-
|-
|}


===Lymph nodes (N)===
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M0


{| {{table}}
| NX
| Regional lymph nodes cannot be assessed.
|-
|-
| N0||No regional lymph node metastasis.
 
! style="background: #DCDCDC;" |
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
 
|-
|-
| N1||Metastases in regional lymph node(s).
|}


===Metastasis (M)===
! style="background: #DCDCDC;" |IV
{| {{table}}
! style="background: #F5F5F5;" |T3
| M0
! style="background: #F5F5F5;" |N1
| No distant metastasis.
! style="background: #F5F5F5;" |M0
|-
|-
| M1||Distant metastasis.
!
!T4
!N0
!M0
|-
!
!T4
!N1
!M0
|-
!
!Any T
!Any N
!M1
|}
|}
A new study showed staging system that incorporates the patient's age better and predicts 5-year survival among patients with stages I/II ACC. Consideration should be given to include age in staging for ACC, because it may better inform providers about treatment and prognosis.<ref name="pmid25456914">{{cite journal| author=Asare EA, Wang TS, Winchester DP, Mallin K, Kebebew E, Sturgeon C| title=A novel staging system for adrenocortical carcinoma better predicts survival in patients with stage I/II disease. | journal=Surgery | year= 2014 | volume= 156 | issue= 6 | pages= 1378-85; discussion 1385-6 | pmid=25456914 | doi=10.1016/j.surg.2014.08.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25456914  }}</ref>


==References==
==References==
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[[Category:Endocrinology]]
[[Category:Types of cancer]]
[[Category:Disease]]

Latest revision as of 18:54, 30 October 2017


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]

Overview

According to the TNM staging system, there are four stages of adrenocortical cancer based on the tumor size, lymph nodes, and distant metastasis. Each stage is assigned a number and letter that designates the number of lymph nodes involved and presence/absence of distant metastasis.

Staging of adrenocortical carcinoma

The AJCC has designated staging by TNM to define adrenocortical carcinoma: [1]

Adrenal cancer TNM staging
Stage Description
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤5 cm in greatest dimension limited to the adrenals
T2 Tumor >5 cm in greatest dimension, limited to the adrenals
T3 Tumor of any size with local invasion, but not invading adjacent organs
T4 Tumor of any size with invasion of adjacent organs
Regional Lymph Nodes (N)
Stage Description
NX Regional lymph node cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
Distant Metastasis (M)
Stage Description
M0 No distant metastasis
M1 Distant metastasis
Anatomic Stage/Prognostic Groups
Stage T N M
I T1 N0 M0
II T2 N0 M0
III T1 N1 M0
T2 N1 M0
T3 N0 M0
IV T3 N1 M0
T4 N0 M0
T4 N1 M0
Any T Any N M1

A new study showed staging system that incorporates the patient's age better and predicts 5-year survival among patients with stages I/II ACC. Consideration should be given to include age in staging for ACC, because it may better inform providers about treatment and prognosis.[2]

References

  1. ↑ Edge SB, Compton CC (2010). "The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM". Ann Surg Oncol. 17 (6): 1471–4. doi:10.1245/s10434-010-0985-4. PMID 20180029.
  2. ↑ Asare EA, Wang TS, Winchester DP, Mallin K, Kebebew E, Sturgeon C (2014). "A novel staging system for adrenocortical carcinoma better predicts survival in patients with stage I/II disease". Surgery. 156 (6): 1378–85, discussion 1385-6. doi:10.1016/j.surg.2014.08.018. PMID 25456914.

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