Colorectal cancer (staging)
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There are two main staging schemes used in colorectal carcinoma. Duke's has largely been replaced by the TNM system, but is nonetheless often used clinically.
Duke's (Astler-Coller modification)
- stage A: confined to mucosa
- stage B: though muscularis propria
- stage C: local lymph node involvement
- stage D: distant metastases
TNM staging
Primary tumour staging (T)
- Tx: primary tumour cannot be assessed
- T0: no evidence of primary tumour
- Tis: carcinoma in situ
- T1: into (but not through) submucosa
- T2: into (but not through) muscularis propria
-
T3
- through muscularis propria into subserosa, or
- into non-peritonealized pericolic / perirectal tissues
- T4: direct extension into adjacent organs
Nodal status (N)
- Nx: nodes cannot be assessed
- N0: no evidence of nodal involvement
- N1: involvement of 1 to 3 regional nodes
- N2: involvement of 4 or more nodes
Metastases (M)
- Mx: presence of metastases cannot be assessed
- M0: no evidence of metastases
- M1: distant metastases present
-<a name="Duke.27s_.28Astler-Coller_modification.29"></a><p>There are two main staging schemes used in <a href="/articles/colorectal-carcinoma" title="Colorectal carcinoma">colorectal carcinoma</a>. Duke's has largely been replaced by the <a href="/articles/tnm-staging-system">TNM system</a>, but is nonetheless often used clinically. </p><h5><span>Duke's (Astler-Coller modification) </span></h5><ul><li><strong>stage A</strong> : confined to mucosa</li><li><strong>stage B</strong> : though muscularis propria</li><li><strong>stage C</strong> : local lymph node involvement</li><li><strong>stage D</strong> : distant metastases</li></ul><a name="TNM"></a><h5><span>TNM staging</span></h5><h6>Primary tumour staging (T)</h6><ul><li><strong>Tx</strong> : primary tumour cannot be assessed</li><li><strong>T0</strong> : no evidence of primary tumour</li><li><strong>Tis</strong> : <a href="/articles/carcinoma-in-situ" title="carcinoma in situ">carcinoma in situ</a></li><li><strong>T1</strong> : into (but not through) submucosa</li><li><strong>T2</strong> : into (but not through) muscularis propria </li><li><strong>T3</strong><ul><li>through muscularis propria into subserosa, or</li><li>into non-peritonealized pericolic / perirectal tissues</li></ul></li><li><strong>T4</strong> : direct extension into adjacent organs</li></ul><a name="N_-_Nodes"></a><h6>Nodal status (N)</h6><ul><li><strong>Nx</strong> : nodes cannot be assessed</li><li><strong>N0</strong> : no evidence of nodal involvement</li><li><strong>N1</strong> : involvement of 1 to 3 regional nodes </li><li><strong>N2</strong> : involvement of 4 or more nodes</li></ul><a name="M_-_Metastases"></a><h6><span>Metastases (M)</span></h6><ul><li><strong>Mx</strong> : presence of metastases cannot be assessed</li><li><strong>M0</strong> : no evidence of metastases</li><li><strong>M1</strong> : distant metastases present</li></ul>- +<p> </p><p>There are two main staging schemes used in <a href="/articles/colorectal-carcinoma">colorectal carcinoma</a>. Duke's has largely been replaced by the <a href="/articles/tnm-staging-system">TNM system</a>, but is nonetheless often used clinically.</p><h5>Duke's (Astler-Coller modification)</h5><ul>
- +<li>
- +<strong>stage A</strong> : confined to mucosa</li>
- +<li>
- +<strong>stage B</strong> : though muscularis propria</li>
- +<li>
- +<strong>stage C</strong> : local lymph node involvement</li>
- +<li>
- +<strong>stage D</strong> : distant metastases</li>
- +</ul><p> </p><h5>TNM staging</h5><h6>Primary tumour staging (T)</h6><ul>
- +<li>
- +<strong>Tx</strong> : primary tumour cannot be assessed</li>
- +<li>
- +<strong>T0</strong> : no evidence of primary tumour</li>
- +<li>
- +<strong>Tis</strong> : <a href="/articles/carcinoma-in-situ">carcinoma in situ</a>
- +</li>
- +<li>
- +<strong>T1</strong> : into (but not through) submucosa</li>
- +<li>
- +<strong>T2</strong> : into (but not through) muscularis propria</li>
- +<li>
- +<strong>T3</strong><ul>
- +<li>through muscularis propria into subserosa, or</li>
- +<li>into non-peritonealized pericolic / perirectal tissues</li>
- +</ul>
- +</li>
- +<li>
- +<strong>T4</strong> : direct extension into adjacent organs</li>
- +</ul><p> </p><h6>Nodal status (N)</h6><ul>
- +<li>
- +<strong>Nx</strong> : nodes cannot be assessed</li>
- +<li>
- +<strong>N0</strong> : no evidence of nodal involvement</li>
- +<li>
- +<strong>N1</strong> : involvement of 1 to 3 regional nodes</li>
- +<li>
- +<strong>N2</strong> : involvement of 4 or more nodes</li>
- +</ul><p> </p><h6>Metastases (M)</h6><ul>
- +<li>
- +<strong>Mx</strong> : presence of metastases cannot be assessed</li>
- +<li>
- +<strong>M0</strong> : no evidence of metastases</li>
- +<li>
- +<strong>M1</strong> : distant metastases present</li>
- +</ul>
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