Staging and Grading Tumors

Question 1

What is the purpose of staging and grading?

Answer 1

• stage and grade determine prognosis
• staging reflects the clinical extent of the tumor
• grading a tumor reflects its histological subtype
• of the two, staging is the primary indicator of prognosis

Question 2

Grading

Answer 2

• degree of differentiation exhibited by cells
• how closely cells resemble normal tissue structure
• grade I: low grade
• grade II: moderately differentiated
• grade III: poorly differentiated

Question 3

Staging

Answer 3

• based in the size and extent of metastatic spread of the lesion
• tumor-node-metastasis (TNM) system used for most cancers

Question 4

Staging - TNM system

Answer 4

• size, in cm, of the tumor (T)
• involvement of lymph nodes (N)
• presence or absence of distant metastasis (M)

Question 5

Staging - T

Answer 5

Tx - no info available on primary tumor
T0 - no evidence of primary tumor
Tis - carcinoma in situ at primary site
T1 - tumor <2cm
T2 - tumor 2-4cm in diameter
T3 - tumor >4cm 
T4 - tumor has invaded adjacent structures

Question 6

Staging - N

Answer 6

Nx - nodes not assessed
N0 - no clinically positive lymph nodes
N1 - single clinically positive ipsilateral node <3cm
N2 - single or multiple clinically positive ipsilateral nodes 3-6cm OR bilateral/contralateral nodes all <6cm
N3 - node or nodes >6cm

Question 7

Staging - M

Answer 7

Mx - distant metastasis not assessed
M0 - no distant metastasis
M1 - distant metastasis is present

Question 8

Five main groups of cancer

Answer 8

• in situ: abnormal cells present
• localized: cancer is limited to the organ in which it began, w/o evidence of spread
• regional: cancer has spread beyond the primary site to nearby lymph nodes or tissues/organs
• distant: cancer has spread from primary site to distant tissues/organs/lymph nodes
• unknown: not even info to determine stage