Staging

Question 1

TNM staging system:

TX - primary can’t be assessed

TO - define?

Tis - pre-invasive cancer

T 1 - 3 - different degrees of local spread

T4 - general invasion into/through adjacent organs

Difference between M0 and M1?

Answer 1

T0 - no evidence of primary tumour

M0 - curable - neoadjuvant chemo/radiotherapy

M1 - invariably fatal

Question 2

Ann Arbor Staging system:

Define stages 1 - 4?

Additional substaging variables include:

What do the following mean?

• A
• B
• F
• S
• X

Answer 2

Stage 1 - ONE node, extralymphatic organ or site

Stage 2 - TWO or MORE etc - SAME side of diaphragm

Stage 3 - BOTH SIDES of the diaphragm (can be one on each side)

Stage 4 - Diffuse or disseminated involvement of ONE or MORE extra lymphatic organs, distal disease (e.g. liver, bone marrow, pleura etc.)

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A - asymptomatic

B - the presence of B symptoms (Fever, night sweats, WL > 10% over 6 months)

E - Extranodal site involvement (e.g. thymus, spleen etc.)

S - splenic involvement

X - bulky nodal disease - nodal mass > THIRD of intrathoracic diameter