Table I.
TNM | Stage | Extension to | |
---|---|---|---|
Tis N0 M0 | 0 | Carcinoma in situ: intraepithelial or invasion of lamina propria | |
T1 N0 M0 | I | Submucosa | |
T2 N0 M0 | I | Muscularis propria | |
T3 N0 M0 | IIA | Subserosa/perirectal tissue | |
Substaginga | T3a | Less than 1 mm | |
T3b | 1–5 mm | ||
T3c | 5–15 mm | ||
T3d | 15 + mm | ||
T4 N0 M0 | IIB | (b) Perforation into visceral peritoneum; or (a) invasion to other organsb | |
T1–2 N1 M0 | IIIA | 1–3 regional nodes involved | |
T3–4 N1 M0 | IIIB | 1–3 regional nodes involvedc | |
T1–4 N2 M0 | IIIC | 4 or more regional nodes involved | |
T1–4 N1–2 M1 | IV | Distant metastases |
aThis subclassification based upon an evaluation using MRI prior to treatment decision is clinically valuable, and used when describing the treatment strategy for primary rectal cancer. It can be used also in the histopathological classification but is not yet validated and therefore not incorporated in any of the TNM versions 5–7.
bThis is the subclassification in TNM 5. It has been reversed in TNM 6 and 7.
cLymph node classification is modified in TNM 7. Tumour cell deposits without a visible lymph node structure are also considered. It is recommended to investigate at least 12 nodes for proper staging.