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Blog, Colorectal Cancer

Colorectal Cancer-Staging


Colorectal cancer staging helps to determine the disease prognosis and to select an appropriate treatment strategy. TNM is the most commonly used staging system for colorectal cancer. It uses mainly 3 parameters: “T” stands for “Tumor”; “N” for “Lymph Nodes”; and “M” for “Metastasis”. Numbers and/or letters after T (0, is, 1, 2, 3, and 4), N (0, 1, and 2), and M (0 and 1) provide more details about each of these parameters. Once T, N, and M are determined, it is used to assign an overall stage (from 0 to IV). Following table describes the detailed TNM staging for colorectal cancer.

t staging colon cancer

n and m staging colon cancer

 Stage TNM Score Description

 

0 Tis N0 M0 Pre-cancerous or cancer cells present only in the superficial layer (epithelium) of colorectal mucosa

 

I T1-2 N0 M0 Cancer extends to the lamina propria or muscular layer (muscularis propria) without spread to regional lymph nodes or distant sites.
IIA T3 N0 M0 Cancer extends through the muscularis propria into the pericolorectal tissues without spread to regional lymph nodes or distant sites.
IIB T4a N0 M0 Cancer has invaded up to the outermost serosa layer (or visceral peritoneum) without spread to regional lymph nodes or distant sites.
IIC T4b N0 M0 Cancer has invaded into the adjacent structures/organs like small intestine, kidneys, pancreas, or stomach without spread to regional lymph nodes or distant sites.
IIIA T1-2 N1/1c M0

OR

T1 N2a M0

Cancer has invaded up to the muscular layer and has spread to 1 to 3 nearby lymph nodes/no lymph node but only the fat around lymph nodes.

OR

Cancer has invaded up to the submucosa layer and has spread to 4 to 6 nearby lymph nodes.

 

IIIB

 

T3-4a N1/1c M0

 

 

OR

T2-3 N2a M0

 

OR

T1-2 N2b M0

 

Cancer has invaded up to the outermost serosa layer (or visceral peritoneum) and has spread to 1 to 3 nearby lymph nodes/no lymph node but only the fat around lymph nodes.

OR

Cancer has invaded  into the muscularis propria or pericolorectal tissue and has spread to 4 to 6 nearby lymph nodes.

OR

Cancer has invaded up to the muscularis propria and has spread to >/=7 nearby lymph nodes.

 

IIIC

 

T4a N2a M0

 

              OR

T3-4a N2b M0

 

              OR

T4b N1-2 M0

 

Cancer has invaded up to the outermost serosa layer (or visceral peritoneum) and has affected 4 to 6 nearby lymph nodes.

OR

Cancer has invaded into pericolorectal tissues or serosa and has spread to >/=7 nearby lymph nodes.

OR

Cancer has invaded into the adjacent organs/structures and has affected 1 to 4 nearby lymph nodes.

 

IVA

 

Any T Any N M1a

 

Cancer has spread to one distant organ without peritoneal spread.

IVB Any T Any N M1b Cancer that has spread to >/=2 distant organs without peritoneal spread.
IVC Any T Any N M1c Cancer that has spread to peritoneum with or without other sites.

 

Also read: Colon cancer treatment.

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