diagnosis staging grading Flashcards
patient pathway
- screening / signs and symptoms
- abnormality detected
- presents to primary healthcare provider
- investigation —— diagnosis —- staging&grading
staging
decides anatomical extent (tumour stage)of tumour
grading
decides type of cells within tumour
why are staging and grading used ?
- predict clinical behaviours of malignancies
- shows appropiate treatment
- gives clear info between clinicians
aim of staging pt1
- help clinician plan best treatment strategy
- indicates prognosis
- helps evaluate the results of treatment
aims of staging pt2
- facilitate exchange of info between tx centres
- contributes to further investigations of cancers
TNM systems is for
tumour
TNM seperates patients into categories depending on
the size of tumour
TNM is based on 3 components
T- extent of primary tumour
N- absence/presence & extent of regional lymph nodes metastasis
M- absence/ presence of distant mestastasis
T0=
Tis=
T1,T2,T3,T4=
TX=
- no evidence of primary tumour
- carcinoma in situ
- increasing size &/or local extension of pt
- pt cant be assessed
T1=
less /= 2cm in diameter
t2=
between 2 and 4 cm
t3=
more than 4cm
t4=
tumour evade adjacent structures
N0=
no regional lymph node mestastasis
N1,N2,N3
increasing no. of extent of regional lymph node involvement
Nx
pt cannot be assessed
M0
no distant metastases
M1
distant metastases present
TNM classification
- clinical classification. cTNM or TNM… b4 treatment
- pathologic classification. pTNM… after resection of pt
purpose of pTNM
- to determine the diameter of the pt
- to determine area of invasion& extent of invasion of blood vessels
- to prove or exclude the involvement of lymph nodes
what is aTNM
classification of a patients post mortum (autopsy) examination
TNM stage grouping
stage 0-
stage I ,II,III-
stage IV
=carcinoma in situ
=indicating relatively greater anatomic extent of cancer
=usually cases w/ distant metastases
