Colorectal Cancer ____________________________________________________________________________
STAGES OF COLORECTAL CANCER
Stage
TNM Classification Tis, N0, M0
Description
Stage 0
Tumor is in the earliest stage and has not grown beyond the colon or rectum mucosa. Also termed carcinoma in situ. Tumor extends through the muscularis mucosa into the submucosa (T1) or into the muscularis propria (T2). Tumor extends into the outermost layers of the colon or rectum but not beyond (T3). Tumor extends through the wall of the colon or rectum but not into adjacent tissues or organs (T4a). Tumor extends through the wall of the colon or rectum and is attached to or has grown into adjacent tissues or organs (T4b). Tumor extends through the mucosa into the submucosa (T1) or into the muscularis propria (T2). It has spread to 1–3 regional lymph nodes (N1) or into areas of fat near regional lymph nodes but not into the nodes (N1c). Tumor extends through the mucosa into the submucosa (T1) and has spread to 4–6 regional lymph nodes (N2a).
Stage I
T1–2, N0, M0
Stage IIA T3, N0, M0 Stage IIB T4a, N0, M0
Stage IIC T4b, N0, M0
Stage IIIA T1–2, N1/N1c, M0
T1, N2a, M0
Stage IIIB T3–4a, N1/N1c, M0
The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 1–3 regional lymph nodes (N1a/N1b) or into areas of fat near regional lymph nodes but not the nodes themselves (N1c). T2–3, N2a, M0 The cancer has grown into the muscularis propria (T2) or into the outermost layers of the colon or rectum (T3). It has spread to 4–6 regional lymph nodes (N2a). T1–2, N2b, M0 The cancer has grown through the mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has spread to 7 or more regional lymph nodes (N2b). The cancer has grown through the wall of the colon or rectum (including the visceral peritoneum) but has not reached nearby organs (T4a). It has spread to 4–6 regional lymph nodes (N2a). T3–4a, N2b, M0 The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 7 or more regional lymph nodes (N2b). T4b, N1–2, M0 The cancer has grown through the wall of the colon or rectum and is attached to or
Stage IIIC T4a, N2a, M0
has grown into other nearby tissues or organs (T4b). It has spread to at least one (up to three) regional lymph node or into areas of fat near the lymph nodes (N1 or N2). The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to regional lymph nodes. It has spread to one distant organ or set of lymph nodes (M1a). The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to regional lymph nodes. It has spread to more than one distant organ or set of lymph nodes, or it has spread to distant parts of the peritoneum (M1b). The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to regional lymph nodes. It has spread to more than one distant organ or set of lymph nodes, or it has spread to one or more distant organs distant parts of the peritoneum (M1c).
Stage IVA Any T, Any N, M1a
Stage IVB Any T, Any N, M1b
Stage IVC Any T, Any N, M1c
Source: [206]
Table 7
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MDAZ2326
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