Colorectal cancer staging
Publication date: September 26, 2012 | Updated on December 19, 2012
Report
Diagnosis
Colorectal cancer staging
History
Primary Tumor (T)
- TX Primary tumor cannot be assessed
- T0 No evidence of primary tumor
- Tis Carcinoma in situ: intraepithelial or invasion of lamina propria
- T1 Tumor invades submucosa
- T2 Tumor invades muscularis propria
- T3 Tumor invades through the muscularis propria into pericolorectal tissues
- T4a Tumor penetrates to the surface of the visceral peritoneum
- T4b Tumor directly invades or is adherent to other organs or structures
Regional Lymph Nodes (N)
- NX Regional lymph nodes cannot be assessed
- N0 No regional lymph node metastasis
- N1 Metastasis in 1–3 regional lymph nodes
- N1a Metastasis in one regional lymph node
- N1b Metastasis in 2–3 regional lymph nodes
- N1c Tumor deposit(s) in the subserosa, mesentery, or nonperitonealized pericolic or perirectal tissues without regional nodal metastasis
- N2 Metastasis in 4 or more regional lymph nodes
- N2a Metastasis in 4–6 regional lymph nodes
- N2b Metastasis in 7 or more regional lymph nodes
Distant Metastasis (M)
- M0 No distant metastasis
- M1 Distant metastasis
- M1a Metastasis confined to one organ or site (for example, liver, lung, ovary, nonregional node)
- M1b Metastases in more than one organ/site or the peritoneum
Stage
T
N
M
Dukes
MAC
0
Tis
N0
M0
–
–
I
T1
N0
M0
A
A
T2
N0
M0
A
B1
IIA
T3
N0
M0
B
B2
IIB
T4a
N0
M0
B
B2
IIC
T4b
N0
M0
B
B3
IIIA
T1–T2
N1/N1c
M0
C
C1
T1
N2a
M0
C
C1
IIIB
T3–T4a
N1/N1c
M0
C
C2
T2–T3
N2a
M0
C
C1/C2
T1–T2
N2b
M0
C
C1
IIIC
T4a
N2a
M0
C
C2
T3–T4a
N2b
M0
C
C2
T4b
N1–N2
M0
C
C3
IVA
Any T
Any N
M1a
–
–
–
IVB
Any T
Any N
M1b
–
Appendix
ileocolic
Caecum
ileocolic, right colic
Ascending colon
ileocolic, right colic, middle colic
Hepatic flexure
middle colic, right colic
Transverse colon
right colic, middle colic, left colic, inferior mesenteric
Splenic flexure
middle colic, left colic, inferior mesenteric
Descending colon
left colic, inferior mesenteric
Sigmoid colon
sigmoid, left colic, superior rectal (haemorrhoidal), inferior mesenteric and rectosigmoid
Rectum
superior, middle, and inferior rectal (haemorrhoidal), inferior mesenteric, internal iliac, mesorectal (paraproctal), lateral sacral, presacral, sacral promontory (Gerota)