Tumour Grade and Stage

Question 1

What is a tumour grade?

Answer 1

Reflects how closely it resembles (microscopically) the normal tissue from which it has arisen. Assesses differentiation.

Question 2

What assesses the aggressiveness of the behaviour of a cancer?

Answer 2

Grading

Question 3

What is required for the grading of a tumour?

Answer 3

Histopathological assessment

Question 4

How are tumours graded?

Answer 4

1. Commonly 3-tier system; well, moderately, and poorly differentiated.
2. Fuhrman system for renal cell carcinoma: 1-4
3. Gleason score for prostatic carcinoma: 1-5

Question 5

What is a tumour stage?

Answer 5

Assessment of the extent of anatomical spread of a tumour.

Question 6

What is the most important prognostic factor for a cancer?

Answer 6

Staging

Question 7

How is a tumour stage decided?

Answer 7

1. Clinically - physical examination
2. Radiological - CT, MRI, PET, USS
3. Surgical
4. Pathological - microscopic examination of tissues

Question 8

What is the most common tumour staging system and how is it broken down?

Answer 8

TMN:
1. local Tumour spread
2. regional lymph Node metastases
3. presence of distant Metastases
Then an overall stage is assigned (I, II, III, IV)

Question 9

How are cancers from a hollow viscus vs cancers from other sites assessed in the T staging?

Answer 9

1. Hollow viscus - how deep they invade the wall of the viscus and adjacent structures
2. Other sites -maximum dimension and invasion of adjacent structures

Question 10

What systems are used to stage these cancers?

1. Gynaecological cancers
2. Lymphomas
3. Colorectal cancer

Answer 10

1. FIGO
2. Ann Arbor
3. Duke’s and TNM