Part of Cancer staging guidance sheets
Appendix (ICD10 C18.1)
Introduction
This is the data sheet for TNM 8th edition staging of the appendix (ICD10 C18.1).
For more detailed information regarding TNM staging, please see pages 70-72 of the UICC TNM 8 book or visit the Wiley and UICC website.
Stage groupings
|
Stage Group |
T stage |
N stage |
M stage |
Grade |
|---|---|---|---|---|
|
Stage 0 |
Tis |
N0 |
M0 |
|
|
Stage 0 |
Tis (LAMN) |
N0 |
M0 |
|
|
Stage I |
T1, T2 |
N0 |
M0 |
|
|
Stage IIA |
T3 |
N0 |
M0 |
|
|
Stage IIB |
T4a |
N0 |
M0 |
|
|
Stage IIC |
T4b |
N0 |
M0 |
|
|
Stage IIIA |
T1, T2 |
N1 |
M0 |
|
|
Stage IIIB |
T3, T4 |
N1 |
M0 |
|
|
Stage IIIC |
Any T |
N2 |
M0 |
|
|
Stage IVA |
Any T |
Any N |
M1a |
|
|
|
Any T |
Any N |
M1b |
G1 |
|
Stage IVB |
Any T |
Any N |
M1b |
G2, G3, GX |
|
Stage IVC |
Any T |
Any N |
M1c |
Any G |
TNM clinical classification
T - primary tumour
| T value | Description |
|---|---|
|
TX |
Primary tumour cannot be assessed |
|
T0 |
No evidence of primary tumour |
|
Tis |
Carcinoma in situ: intraepithelial or invasion of lamina propria |
|
Tis (LAMN) |
Low‐grade appendiceal mucinous neoplasm confined to the appendix (defined as involvement by acellular mucin or mucinous epithelium that may extend into muscularis propria) |
|
T1 |
Tumour invades submucosa |
|
T2 |
Tumour invades muscularis propria |
| T3 |
Tumour invades subserosa or mesoappendix |
|
T4 |
Tumour perforates visceral peritoneum, including mucinous peritoneal tumour or acellular mucin on the serosa of the appendix or mesoappendix and/or directly invades other organs or structures T4a - Tumour perforates visceral peritoneum, including mucinous peritoneal tumour or acellular mucin on the serosa of the appendix or mesoappendix T4b - Tumour directly invades other organs or structures |
N - regional lymph nodes
| N value | Description |
|---|---|
|
NX |
Regional lymph nodes cannot be assessed |
|
N0 |
No regional lymph node metastasis |
|
N1 |
Metastasis in 1 to 3 regional lymph nodes |
|
|
N1a - Metastases in 1 regional lymph node N1b - Metastases in 2–3 regional lymph nodes N1c - Tumour deposit(s), i.e. satellites,* in the subserosa, or in non‐peritonealized pericolic or perirectal soft tissue without regional lymph node metastasis |
|
N2 |
Metastasis in 4 or more regional lymph nodes |
Notes:
* Tumour deposits (satellites) are discrete macroscopic or microscopic nodules of cancer in the pericolorectal adipose tissue’s lymph drainage area of a primary carcinoma that are discontinuous from the primary and without histological evidence of residual lymph node or identifiable vascular or neural structures. If a vessel wall is identifiable on H&E, elastic or other stains, it should be classified as venous invasion (V1/2) or lymphatic invasion (L1). Similarly, if neural structures are identifiable, the lesion should be classified as perineural invasion (Pn1).
M - distant metastasis
| M value | Description |
|---|---|
|
M0 |
No distant metastasis |
|
M1 |
Distant Metastasis M1a - Intraperitoneal acellular mucin only M1b - Intraperitoneal metastasis only, including mucinous epithelium M1c - Non‐peritoneal metastasis |
TNM pathological classification
pT - primary tumour
The pT categories correspond to the T categories as per above.
pN - regional lymph nodes
Histological examination of a selective neck dissection specimen will ordinarily include 10 or more lymph nodes. Histological examination of a radical or modified radical neck dissection specimen will ordinarily include 15 or more lymph nodes.
| pN value | Description |
|---|---|
|
pN0 |
Histological examination of a regional lymphadenectomy specimen will ordinarily include 12 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0 |
Last edited: 14 December 2022 11:05 am
