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Cancer Staging Systems

Staging of colon cancer

TNM definition

Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• Tis: Carcinoma in situ: intraepithelial or invasion of the lamina propria
• T1: Tumor invades submucosa
• T2: Tumor invades muscularis propria
• T3: Tumor invades through the muscularis propria into the subserosa, or into nonperitonealized pericolic or perirectal tissues
• T4: Tumor directly invades other organs or structures, and/or perforates visceral peritoneum

Regional lymph nodes (N)

• NX: Regional nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1: Metastasis in 1 to 3 regional lymph nodes
• N2: Metastasis in 4 or more regional lymph nodes

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1: Distant metastasis

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Stage grouping

Stage 0

• Tis, N0, M0

Stage I

• T1, N0, M0
• T2, N0, M0

Stage IIA

• T3, N0, M0

Stage IIB

• T4, N0, M0

Stage IIIA

• T1, N1, M0
• T2, N1, M0

Stage IIIB

• T3, N1, M0
• T4, N1, M0

Stage IIIC

• Any T, N2, M0

Stage IV

• Any T, Any N, M1

References

1. Colon and rectum. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 113-124.

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