3.6 Staging of cancer

Question 1

Why do we stage cancer?

Answer 1

Planning treatment
Accurate communication between physicians
Assessment of treatment
Create a flowchart of management and treatment

Question 2

When should staging be applied?

Answer 2

At the time of diagnosis

Question 3

What is not part of staging?

Answer 3

Tumour grade
Histological subtype
Microscopic features
Patient symptoms

Question 4

What is the T stage

Answer 4

Tumour 
Tx = not accessible 
T0 = no evidence of primary 
Tis = Carcinoma in situ (no invasion and not malignan) 
T1-4 = increasing size or local extent

Question 5

What is teh N stage?

Answer 5

Node
Nx = not accessible
N0 = no regional lymph node mets
N1-3 = increasing involvement

Question 6

What is the M stage

Answer 6

Metastases
M0 = no mets
M1 = mets

Question 7

What is pT?

Answer 7

Pathologic tumour (stage has been determined after resection)

Question 8

What is ypN

Answer 8

Pathologic stage of nodes post chemotherapy

Question 9

What is R staging?

Answer 9

Residual tumour post resection
R0 = no residual tumour
R1 = microscopic residual tumour
R2 = macroscopic

Question 10

What is sn staging?

Answer 10

Sentinel node involvement

Question 11

What does ypN1(sn) mean?

Answer 11

after chemotherapy a sentinel node was positive

Question 12

What is the T stage in breast cancer?

Answer 12

Tx = Primary cannot be assessed
Tis = in situ disease only 
T0 = no primary 
T1 = 2 5cm 
T4 = tumour involving chest wall or skin

Question 13

What is the N stage in breast cancer?

Answer 13

N0 = none 
N1 = 1-3 axillary nodes 
N2 = >3 axillary or apparent internal mammary 
N3= > = 10

Question 14

What TNM is stage 1 breast cancer?

Answer 14

T1, N0, M0

Question 15

What TNM is stage 2 breast ?

Answer 15

as soon as there is nodal involvement (only up to N1)
T0, T1 and T2 with N1 M0
OR
T3 N0 M0

Question 16

What TNM is stage 3a breast ?

Answer 16

T0-2 with N2 M0

T3 with N1 or N2 M0

Question 17

What TNM is stage 3b breast?

Answer 17

T4, N0-2, M0

Question 18

What TNM is stage 3c breast?

Answer 18

any T, N3, M0

Question 19

What TNM is stage 4 breast?

Answer 19

Ant T, N, M1

Question 20

What is the T stage in colorectal cancer?

Answer 20

Tis = just in muscularis mucosa 
T1 = extends into submucosa 
T2 = extends into muscularis propria
T3 = Grown through the muscularis propria to outer layers but not through them
T4 = Through the serosa to adjacent organs

Question 21

What is the N stage of colorectal cancer?

Answer 21

N1 = 1-3 mesenteric nodes 
N2 = >=4 mesenteric nodes

Question 22

What TNM is stage 1 colon cancer?

Answer 22

T1 or T2, N0 M0

Question 23

What TNM is stage 2 colon cancer?

Answer 23

T3 or T4 N0 M0

Question 24

What TNM is stage 3 colon cancer?

Answer 24

Any T, N1 or 2, M0

Question 25

What TNM is stage 4 colon cancer?

Answer 25

Any T, N M1