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Cancer Staging and Grading

Cancer staging describes the severity and extent of a patient's cancer. It is an important process for determining the appropriate treatment plan and prognosis. The most common system used for staging is the TNM system developed by the American Joint Committee on Cancer, which evaluates the size and spread of the primary tumor (T), lymph node involvement (N), and distant metastasis (M). Once these are determined, an overall stage from 0 to IV is assigned, with higher stages indicating more advanced or widespread cancer. Cancer grading also provides information by classifying tumor cells from well differentiated to undifferentiated.

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230 views

Cancer Staging and Grading

Cancer staging describes the severity and extent of a patient's cancer. It is an important process for determining the appropriate treatment plan and prognosis. The most common system used for staging is the TNM system developed by the American Joint Committee on Cancer, which evaluates the size and spread of the primary tumor (T), lymph node involvement (N), and distant metastasis (M). Once these are determined, an overall stage from 0 to IV is assigned, with higher stages indicating more advanced or widespread cancer. Cancer grading also provides information by classifying tumor cells from well differentiated to undifferentiated.

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juliusromatolentino
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CANCER STAGING and GRADING

The process of finding the extent or severity of a patients Cancer. describes the severity of a persons cancer based on the extent of the original (primary) tumor and whether or not cancer has spread in the body.

CANCER STAGING

Staging helps the doctor plan the appropriate treatment. The stage can be used to estimate the persons prognosis. Knowing the stage is important in identifying clinical trials that may be suitable for a particular patient.

Staging helps health care providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials.

IMPORTANCE of STAGING

Site of the primary tumor. Tumor size and number of tumors. Lymph node involvement (spread of cancer into lymph nodes). Cell type and tumor grade* (how closely the cancer cells resemble normal tissue cells). The presence or absence of metastasis.

COMMON ELEMENTS of CA STAGING

CLINICAL STAGING This is an estimate of how much cancer there is based on the physical exam, imaging tests (x-rays, CT scans, blood tests, etc.), and tumor biopsies.

a key part of deciding the best treatment to use and the baseline used for comparison when looking at the cancer's response to treatment.

TYPES of STAGING

PATHOLOGIC STAGING Pathological staging (also called surgical staging) relies on information obtained during surgery.

gives the health care team more precise information that can be used to predict treatment response and outcomes (prognosis).

TYPES of STAGING

THE TNM GRADING SYSTEM

Developed by the American Joint Committee on Cancer (AJCC) as a tool for doctors to stage different types of cancer based on certain standards.
In the TNM system, each cancer is assigned a T, N, and M category.

TNM STAGING

Primary Tumor
Describes the size or direct extent of the original (primary) tumor. The tumor size is usually measured in centimeters (2 and 1/2 centimeters is about 1 inch) or millimeters (10 millimeters = 1 centimeter).

T Category

Tx T0 Tis

Primary tumor cannot be evaluated. No evidence of primary tumor Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and is sometimes called preinvasive cancer)

T1

Tumor is 2 cm (3/4 of an inch) or less across.

T2
T3 T4

Tumor is more than 2 cm but not more than 5 cm (2 inches) across.


Tumor is more than 5 cm across.

T Category growing into the chest wall or skin. This Tumor of any size
includes inflammatory breast cancer.

Nodal Involvement
Describes the extent of spread of the tumor cells to the lymph nodes Describes whether or not the cancer has spread into nearby lymph nodes.

N Category

NX N0

Regional lymph nodes cannot be evaluated Means nearby lymph nodes do not contain cancer. Cancer has spread to 1 to 3 lymph node(s). Cancer has spread to 4 to 9 lymph nodes. Cancer has spread to 10 or more lymph nodes.

N1 N2 N3

Distant Metastases
tells whether there are distant metastases (spread of cancer to other parts of body).

M Category

MX M0

Metastasis can't be evaluated No distant metastases were found

M1

Distant metastases were found (the cancer has spread to distant organs or tissues).

M Category

Reflects how abnormal cancer cells look under the microscope.


refers to the classification of the tumor cells. Grading systems seek to define the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and histologic characteristics of the tissue of origin.

CANCER Grading

GX

Cancer cells cannot be determined

G1

Cancer cells are well differentiated

G2

Cancer cells are moderately differentiated

G3

Cancer cells are poorly differentiated

G4

Cancer cells are undifferentiated

CANCER Grading

Once the values for T, N, and M have been determined, they are combined, and an overall stage is assigned.
For most cancers, the stage is a Roman numeral from I to IV. Sometimes stages are subdivided as well, using letters such as A and B

STAGE Grouping

Stage 0 is carcinoma in situ for most cancers. This means the cancer is at a very early stage, is only in the area where it first developed, and has not spread. Not all cancers have a stage 0. Stage I cancers are the next least advanced and often have a good prognosis (outlook for survival). As the stage number goes up the cancers are more advanced (bigger and more widespread), but in many cases they can still be treated.

In Situ

Abnormal cells are present only in the layer of cells in which they developed. Cancer is limited to the organ in which it began, without evidence of spread. Cancer has spread beyond the primary site to nearby lymph nodes or organs and tissues. Cancer has spread from the primary site to distant organs or distant lymph nodes. There is not enough information to determine the stage.

Localized

Regional

Distant

Unknown

Surveillance, Epidemiology, and End Results Program (SEER)

THE END.. :3

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