Colorectal cancer staging: Difference between revisions

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==Overview==
==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 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|TNM classification system]] which depends on the extent of local invasion, the degree of [[Lymph node metastases|lymph node involvement]], and whether there is distant [[metastasis]]. The staging systems are called Duke's classification, [[TNM classification]], and AJCC stage grouping.


==Colorectal Cancer Staging==
==Colorectal Cancer Staging==
*Colorectal cancer staging is an estimate of the amount of penetration of the cancer
*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
*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]]
*The systems for staging colorectal cancers largely depend on the extent of local invasion, the degree of [[Lymph node metastases|lymph node involvement]], and whether there is distant [[metastasis]]
*Definitive staging can only be done after [[Colectomy|surgery]] has been performed and pathology reports have been reviewed
*Definitive staging can only be done after [[Colectomy|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
*An exception to this principle would be after a [[colonoscopic]] [[polypectomy]] of a malignant [[Pedunculated|pedunculated polyp]] with minimal invasion
*Preoperative staging of rectal cancers may be done with [[endoscopic ultrasound]]
*Preoperative staging of   may be done with [[endoscopic ultrasound]]
*Adjuncts to staging of metastasis include [[Medical ultrasonography|abdominal ultrasound]], [[Computed tomography|CT]], [[Positron emission tomography|PET scanning]], and other imaging studies
*Adjuncts to staging of metastasis include [[Medical ultrasonography|abdominal ultrasound]], [[Computed tomography|CT]], [[Positron emission tomography|PET scanning]], and other imaging studies


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The following table describes the Duke's classification stages.
The following table describes the Duke's classification stages.


{| {{table}}
{| style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" cellspacing="0" cellpadding="4" {{table}}


| align="center" style="background:#f0f0f0;"|'''Stage'''
| style="background:#f0f0f0;" align="center" |'''Stage'''


| align="center" style="background:#f0f0f0;"|'''Description'''
| style="background:#f0f0f0;" align="center" |'''Description'''


|-
|-
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===TNM Classification System===
===TNM Classification System===
{{main|TNM}}
{{main|TNM}}
The most common staging system is the [[TNM]] classification (tumors/nodes/metastases) system. The [[TNM]] classification system assigns a number<ref>
The most common staging system is the [[TNM]] classification (tumors/nodes/metastases) system. The [[TNM]] classification system assigns a number<ref>{{cite book  
{{cite book  
|author=Wittekind, Ch; Sobin, L. H.  
|author=Wittekind, Ch; Sobin, L. H.  
|title=TNM classification of malignant tumours  
|title=TNM classification of malignant tumours  
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The table below displays which TNM values represent which stage.
The table below displays which TNM values represent which stage.


{| {{table}}
{| style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" cellspacing="0" cellpadding="4" {{table}}


| align="center" style="background:#f0f0f0;"|'''Stage'''
| style="background:#f0f0f0;" align="center" |'''Stage'''


| align="center" style="background:#f0f0f0;"|'''TNM Value'''
| style="background:#f0f0f0;" align="center" |'''TNM Value'''


|-
|-

Latest revision as of 20:55, 15 December 2017

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To view the staging of familial adenomatous polyposis (FAP), click here
To view the staging of hereditary nonpolyposis colorectal cancer (HNPCC), click here

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, TNM classification, and AJCC stage grouping.

Colorectal Cancer Staging

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 staging system is the TNM classification (tumors/nodes/metastases) 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

References

  1. Dukes CE. The classification of cancer of the rectum. Journal of Pathological Bacteriology 1932;35:323.
  2. Wittekind, Ch; Sobin, L. H. (2002). TNM classification of malignant tumours. New York: Wiley-Liss. ISBN 0-471-22288-7.


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