Table 8. Structural report of surgical resection specimens of colorectum.
Name Sex Age Pathology number Medical record number Inspection site | |
American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) Colorectal Cancer TNM Staging System (8th Edition, 2017) Primary tumor (T) Tx Primary tumor cannot be evaluated T0 No evidence of primary tumor Tis Carcinoma in situ: intramucosal carcinoma (invades lamina propria, but without penetrating the muscularis mucosae) T1 Tumor invades submucosa T2 Tumor invades muscularis propria T3 Tumor invades through muscularis propria into pericolorectal tissues T4 Tumor invades the visceral peritoneum or invades/adheres to adjacent organs or structures T4a Tumor penetrates the visceral peritoneum (including tumor perforation of the gross intestine and continuous infiltration of the tumor through the inflammatory region) T4b Tumor directly invades or adheres to adjacent organs or structures Regional lymph nodes (N) Nx Regional lymph node invaluable N0 No regional lymph node metastasis N1 Metastasis in 1−3 regional lymph nodes (intra-node tumors ≥0.2 mm) or any number of tumor deposits and no metastasis of all identifiable lymph nodes N1a Metastasis in 1 regional lymph node N1b Metastasis in 2−3 regional lymph node N1c There is no regional lymph node metastasis, but there are tumor deposits in the following areas: Subserous, mesenteric or pericolic/rectal mesenteric tissue without peritoneum coverage 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 Metastasis (M) M0 No distant metastasis M1 Metastasis confined to one or more distant sites or organs, or peritoneal metastasis confirmed M1a Metastasis in one site or organ without peritoneal metastasis M1b Metastasis in two or more sites or organs without peritoneal metastasis M1c Metastasis only in the peritoneal surface or along with other sites or organs | |
Specimen size | Length: _____ cm Circumference: _____ cm |
Tumor location | To the proximal end _____ cm, to the distal end _____ cm |
General type | □ Bulge type □ Ulcer type □ Invasive type |
Tumor size | Maximum diameter: _____ cm Other two diameters: _____ cm × _____ cm |
Perforation of tumor | □ Visible □ Invisible □ Uncertain |
Histological classification | □ Adenocarcinoma, non-special type □ Serrated adenocarcinoma □ Adenoma-like adenocarcinoma □ Micropapillary carcinoma □ Mucinous adenocarcinoma □ Poorly cohesive carcinoma □ Signet ring cell carcinoma □ Medullary carcinoma □ Adenosquamous carcinoma □ Undifferentiated carcinoma, non-special type □ Carcinoma with sarcomatoid component |
Histological grade | □ Uncertain □ Low level (well/moderately differentiated) □ High level (poorly differentiated, undifferentiated) |
Tumor invasion (deepest point) | □ Cannot be assessed □ No evidence of primary tumor □ No membrane propria infiltration □ Intramucosal carcinoma, invasion of the membrane propria/muscularis mucosae □ Tumor invades submucosal layer □ Tumor invades the muscularis propria □ Tumor penetrates the muscularis propria to subserosal adipose tissue or pericolic/perirectal soft tissue □ Tumor penetrates the visceral peritoneum (serous membrane) (including tumor perforation of the gross intestine and continuous infiltration of the tumor through the inflammatory region) □ Adhesion of tumor to other organs or structures: □ Tumors directly invade nearby structures: |
Proximal resection margin | □ Cannot be assessed □ No intradermal tumor and dysplasia □ Adenoma (low-grade intraepithelial neoplasia/dysplasia) □ High-grade intraepithelial neoplasia/dysplasia or intramucosal carcinoma □ Invasive cancer involvement |
Distal resection margin | □ Cannot be assessed □ No intradermal tumor and dysplasia □ Adenoma (low-grade intraepithelial neoplasia/dysplasia) □ High-grade intraepithelial neoplasia/dysplasia or intramucosal carcinoma □ Invasive cancer involvement |
Circumferential (radial) or mesangial margin | □ Inapplicable □ Cannot be assessed □ Non-invasive cancer □ Invasive carcinoma (distance between tumor and resection margin less than 1 mm) |
Therapeutic effects (for cancer after neoadjuvant treatment) | □ No pre-treatment □ Therapeutic effect □ No residual tumor (grade 0, complete response) □ Moderate response (grade 1, minor residual tumor) □ Minimal response (grade 2) □ No certain response (grade 3, poor response) □ Uncertain |
Tumor budding | □ Low (visual field of 0−4/20 times) □ Medium (visual field of 5−9/20 times) □ High (visual field of 10 or more/20 times) □ Cannot be assessed |
Vascular invasion | □ Invisible □ Microvascular invasion □ Lymphatic invasion □ Venous invasion □ Uncertain |
Nerve invasion | □ Invisible □ Visible □ Uncertain |
Lymph node | □ No lymph nodes submitted or no lymph nodes found □ No. of lymph nodes examined _____ □ No. of lymph nodes involved _____ |
Extranodal tumor deposits | □ Invisible □ Visible (Number: _____) □ Uncertain |
Immunohistochemistry of mismatch repair protein | MLH1 ( ) PMS2 ( ) MSH2 ( ) MSH6 ( ) |
Pathological stage | □ m (multiple primary tumors) □ r (relapse) □ y (after neoadjuvant treatment) T ___ N ___ M ___ |