Staging Flashcards
Breast cancer staging
T stage
Tis
T1: < 2
T2: 2 - 5cm
T3: >5cm
T4 - involved skin or chest wall
T4a: Involves chest wall (beyond pec)
T4b: Involves skin
T4c: Involves chest wall and skin
T4d: Inflammatory breast cancer
N stage
N0 - no involved nodes
N1 - 1-3 nodes
N2 - 4-9 nodes
N3: >10 axillary nodes or infra or supraclavicular nodes, or internal mammary nodes
M stage
M0
M1
Staging groups
Ia - T1, no nodes
Ib - T0 or T1, micromets to node
IIa - T2N0 or T1N1
IIb - T2N1 or T3N0
IIIa - T3N1 or any TN2
IIIb - T4any N or inflammatory breast ca
IIIc - N3 disease
IV - metastatic disease
Pancreatic cancer
T stage
T1: < 2cm
T2: > 2cm
T3: Beyond pancreas without involvement of SMA or coeliac axis
T4: Involvement of coeliac axis or SMA
N stage
N0: No nodes
N1: Regional nodes involved
M stage
M0: No distant mets
M1: Distant mets
Melanoma staging
Tis
T1a: < 0.8mm
T1b: < 0.8mm ulcerated or <1mm
T2: 1-2mm (a or b)
T3: 2-4mm (a or b)
T4: > 4mm (a or b)
N1a: 1 LN, occult
N1b: 1 LN, clinical
N1c: 0LN, MSI present
N2a: 2-3 LN, occult
N2b: 2-3 LN, clinical
N2c: 1 LN (occult or clinical), MSI present
N3a: 4 or more LN occult
N3b: 4 or more LN clinical
N3c: 2 or more LN (occult or clinical), MSI present
Stage:
1: T1-T2a
2: T2b - T4
3: N disease (a-d)
4: Mets
Merkel Cell staging
T1: <2cm
T2:2-5cm
T3: >5cm
T4: Invasion of bone, muscle, cartilage or fascia
N1: Mets in regional nodes
N1a: Micromets
N1b: Macromets
N2: In transit metsENE, multiple positive nodes, immunosuppressed patients)
cutaneous SCC staging
T1: <2cm
T2: 2-4cm
T3: > 4cm or bone erosion, PNI or deep invasion > 6mm
T4a: Gross cortical bone/ marrow erosion
T4b: Skull base or foramen involvement
N1: Met <3cm in single ipsilateral node with no ENE
N2 - Nodes < 6cm
N2a: Single node (ipsi or contra) <3cm with ENE, or 3-6cm without ENE
N2b: Mets in multiple ipsilat nodes <6cm without ENE
N2c: Mets in bilat nodes <6cm without ENE
N3: Nodes >6cm or >3cm and nasty
N3a: Single node > 6cm and ENE -ve
N3b: Met >3cm with ENE or multiple nodes with ENE
Colonic Cancer staging
T1: Submucosa
T2: Muscularis propria
T3: Serosa
T4: Through peritonum or into adjacent organs
N1: 1-3 nodes
N2: 4 or more nodes
Dukes:
A: Limited to mucosa
B - No LN
B1: Lumited to submucosa, no LN invasion
B2: Limited to muscularis propria, no LN
C: LN mets
C1: Limited to bowel wall, LN mets
C2: Past intestinal wall, LN mets
Appendiceal NET
T1 - <2cm
T2 - 2-4cm
T3 - >4cm or invades mesoappendix
T4 - Invades peritoneum or other organs
N1 - involved nodes
M1 - metastases
Gastric cancer
T1a - mucosa
T1b - submucosa
T2 - muscularis propria
T3 - Serosa
T4 - Invasion through peritoneum or into other structures
N1 - 1-2 nodes
N2 - 3-6 nodes
N3 - 7 or more nodes
Anal cancer staging (same as MErkel)
T1: <2cm
T2: 2-5cm
T3: >5cm, mobile
T4: Invading adjacent organs - vagina, urethra, bladder
N1a: Inguinal, mesorectal or int iliac nodes
N1b: Mets in external iliac nodes
N1c: Mets in both 1a and 1b locations
Rectal cancer
T1 - submucosa
T2 - muscularis propria
T3 - perirectal fat or serosa of peritonealised fortion
T4 - Beyond peritoneum and into adjacent structures
N1 - 1-3 nodes
N2 - 4 or more nodes
Gallbladder cancer
T1a - lamina propria
T1b - muscularis propria
T2 - perimuscular tissue
2a - Peritoneum side
2b - Liver side
T3 - perforated serosa or invades liver or 1 adjacent organ
T4 - Invades PV, HA or at least 2 adjacent organs
N1 - NOdes along CD, CBD, HA or PV
N2 - Mets to periaortic, pericaval, SMA or celiac artery nodes
Oesophageal cancer
T1a - mucosa
T1b - submucosa
T2 - Muscularis propria
T3 - Adventitia
T4 - Invasion of adjacent structures
4a - pleura, pericardium, azygous diaphragm, peritoneum
4b - aorta, vertebral body, trachea
N1 - 1-2 nodes
N2 - 3-6 nodes
N3 - 7 or more nodes
GIST
T1 - <2cm
T2 - 2-5cm
T3 - 5-10cm
T4 - >10cm
N1 - nodes involved
Mitoses
Low - <5 mitoses
high - >5 mitoses
Cholangiocarcinoma (intra-hepatic)
T1a - solitary tumour < 5cm without vascular invasion
T1b - solitary tumour > 5cm with vascular invasion
T2 - solitary tumour with vascular invasion or multiple tumours
T3 - tumour perforating the visceral peritoneum
T4 - Tumour invasion into extrahepatic structures
N1 - positive nodes
Differentiated thyroid Ca
T1a: <1cm
T1b: 1-2cm
T2: 1-2cm
T3a: >4cm
T3b: Invasion of straps
T4a: Invasion of subcut soft tissues, larynx, trachea, oesophagus or RLN
T4b: Invasion of prevertebral fascia or encasing carotid artery of mediastinal vessels
