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

Colon & Rectum
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
Anal Canal
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.