Part of Cancer staging guidance sheets
Colon and rectum (ICD10 C18-C20)
Introduction
This is the data sheet for TNM 8th edition staging of the colon and rectum (ICD10 C18-C20)
For more detailed information regarding TNM staging, please see pages 73-76 of the UICC TNM 8 book or visit the Wiley and UICC website.
Stage groupings
|
Stage Group |
T stage |
N stage |
M stage |
|---|---|---|---|
|
Stage 0 |
Tis |
N0 |
M0 |
|
Stage I |
T1, T2 |
N0 |
M0 |
|
Stage II |
T3, T4 |
N0 |
M0 |
|
Stage IIA |
T3 |
N0 |
M0 |
|
Stage IIB |
T4a |
N0 |
M0 |
|
Stage IIC |
T4b |
N0 |
M0 |
|
Stage III |
Any T |
N1, N2 |
M0 |
|
Stage IIIA |
T1, T2 |
N1 |
M0 |
|
|
T1 |
N2a |
M0 |
|
Stage IIIB |
T1, T2 |
N2b |
M0 |
|
T2, T3 |
N2a |
M0 |
|
|
T3, T4a |
N1 |
M0 |
|
|
Stage IIIC |
T3, T4a |
N2b |
M0 |
|
T4a |
N2a |
M0 |
|
|
T4b |
N1, N2 |
M0 |
|
|
Stage IV |
Any T |
Any N |
M1 |
|
Stage IVA |
Any T |
Any N |
M1a |
|
Stage IVB |
Any T |
Any N |
M1b |
|
Stage IVC |
Any T |
Any N |
M1c |
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: invasion of lamina propria |
|
T1 |
Tumour invades submucosa |
|
T2 |
Tumour invades muscularis propria |
|
T3 |
Tumour invades subserosa or into non‐peritonealized pericolic or perirectal tissues |
|
T4 |
Tumour directly invades other organs or structures and/or perforates visceral peritoneum T4a - Tumour perforates visceral peritoneum T4b - Tumour directly invades other organs or structures 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 - Metastasis in 1 regional lymph node N1b - Metastasis in 2 to 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 N2a - Metastasis in 4–6 regional lymph nodes N2b - Metastasis in 7 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). The presence of tumour deposits does not change the primary tumour T category, but changes the node status (N) to pN1c if all regional lymph nodes are negative on pathological examination.
M - distant metastasis
| M value | Description |
|---|---|
|
M0 |
No distant metastasis |
|
M1 |
Distant metastasis M1a - Metastasis confined to one organ (liver, lung, ovary, non‐regional lymph node(s)) without peritoneal metastases M1b - Metastasis in more than one organ M1c - Metastasis to the peritoneum with or without other organ involvement |
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 12:24 pm
