Cancer Staging

What factors are taken into account when staging ovarian cancer?

Number of ovaries involved Fallopian tubes/uterus/bladder involvement Peritoneal involvement Distant metastases

Give an example TNM that would classify a breast cancer as Stage IV

Any tumour classification with metastases

What are the purposes of staging cancers?

Determines the extent of cancer growth Can help dictate treatment options and management Allows for communication between physicians Facilitates assessment of treatment effectiveness

What does M stand for in TNM? Describe each M classification.

M = metastases Mx = n/a M0 = no metastases M1 = metastases present

What does N stand for in TNM? Describe each N classification.

N = nodal involvement Nx = n/a N0 = no nodal involvement N1 = 1-3 nodes N2 = 4+ nodes

What are the defining characteristics of Stage III and Stage IV colorectal cancers?

Stage III - nodal involvement, no mets Stage IV - metastases present,

What is stage grouping?

Stage grouping combines different TNM combinations into larger stage 'groups'

Define 'staging' with regards to cancer. How does this differ from grading?

Staging is the anatomical extent of cancer, taking into account the depth of invasion and spread to other sites of the body. Grading is the aggressiveness of the cancer.

What does T stand for in TNM? Describe each T classification.

T = primary tumour depth Tx = n/a T0 = no evidence of primary Tis = limited to mucosa T1 = limited to submucosa T2 = limited to muscularis propria T3 = limited to sub-serosa T4 = invades adjacent tissues

Give an example TNM that would classify a breast cancer as Stage I

T1 N0 M0

Give an example TNM that would classify a breast cancer as Stage II

T1N1 T2N0/T2N1 T3N0 i.e. varying sizes w/ or without nodal involvement, no mets

Give an example TNM that would classify a breast cancer as Stage III

T1N2/T1N3 T3N1 T4N0 Larger tumours with/without nodal involvement

What do the following additional descriptors stand for in the TNM staging system? p, y, R, sn

p = stage has been determined after tumour resection (i.e. pathological stagin) y = stage following chemotherapy R = residual tumour present sn = sentinal node positive