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Staging
Criteria for TNM Clinical Staging: Physical examination and history; histologic type; imaging (barium enema, chest x-ray, and so forth), endoscopy, and studies to determine presence or absence of distant metastases
Criteria for TNM Pathologic Staging: Information from clinical staging; surgical exploration; pathologic examination of resected specimen, including depth of penetration into wall of bowel; evaluation of number and location of involved lymph nodes
Synonyms for in situ carcinoma: Stage 0, non-infiltrating, superficial, no invasion of lamina propria, limited to mucosa, non-invasive, no penetration of the basement membrane
The staging for carcinoma of the anal canal is different from that for colon and rectal cancer.
Brief Summaries of 6th Edition Categories
| TNM Classification | Histological/Clinical Features |
|---|---|
| T1 | Invades submucosa |
| T2 | Invades muscularis propria |
| T3 | Invades subserosa, non-peritonealized pericolic/perirectal tissues |
| T4 | Invades other organs or structures/visceral peritoneum |
| N1 | 1- 3 nodes |
| N2 | >3 nodes |
| TNM Classification | Histological/Clinical Features |
|---|---|
| T1 | < 2 cm |
| T2 | 2 cm to 5 cm |
| T3 | > 5 cm |
| T4 | Invades adjacent organs, such as vagina, urethra, bladder |
| N1 | Perirectal lymph node(s) |
| N2 | Unilateral interal iliac and/or inguinal node(s) |
| N3 | Perirectal and inguinal nodes and/or bilateral internal iliac and/or inguinal nodes |
Collaborative Stage Elements
For more details on Collaborative Stage, see the Intro to Collaborative Staging module.