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Cancer Staging Systems

Staging of adrenocortical tumors

Last updated: Thursday, 19 August, 2004.

TNM definition

Primary tumor (T)

• T1: Tumor 5 cm or less in size; invasion absent
• T2: Tumor greater than 5 cm in size; invasion absent
• T3: Tumor outside adrenal in fat
• T4: Tumor invading adjacent organs

Nodal involvement (N)

• N0: No regional positive nodes
• N1: Positive regional nodes

Distant metastasis (M)

• MX: Minimum requirements to assess the presence of distant metastasis cannot be met
• M0: No (known) distant metastasis
• M1: Distant metastasis present

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Stage grouping

Memory Aid:
Stage I corresponds to T1
Stage II corresponds to T2
Stage III corresponds to advanced disease (T3) or local disease (T1,T2) with lymph node metastasis (N1).
Stage IV includes locally advanced disease (T3, T4) with lymph node metastasis (N1) or cases with distant metastasis (M1). See figure.

Stage I

• T1, N0, M0

Stage II

• T2, N0, M0

Stage III

• T3, N0, M0
• T1 or T2, N1, M0

Stage IV

• T3 or T4, N1, M0
• any T, any N, M1

A review of published data from 608 patients revealed the following stage distribution at diagnosis: 3% stage I, 29% stage II, 20% stage III, and 49% stage IV.

References

1. Norton JA, Le HN: Adrenal tumors. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001, pp 1770-1787.
2. Wooten MD, King DK: Adrenal cortical carcinoma. Epidemiology and treatment with mitotane and a review of the literature. Cancer 72 (11): 3145-55, 1993. 

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