, Case 1
TNM-classification
·
-
Clinical classification (cTNM) Pathological classification (pTNM)
Designated before treatment to select and evaluate therapy. Designated after surgery to guide adjuvant therapy, estimate
-
prognosis and calculate end results.
T = extent of primary tumor.
T = primary tumor can't be assessed.
·
X
T = no evidence as primary tumor.
·
O
T = carcinoma in situ.
·
is
T - T = size and/or extent of primary tumor.
·
1 4 But evaluated histologically
N = extent of spread to lymph nodes.
N = regional lymph nodes can't be assessed.
·
X
·N = no regional lymph node involvement.
N - N = extend of spread to lymph nodes.
·
1 3
M = presence of metastasis to other parts of body.
M = no distant metastasis.
·
1M = distant metastasis.
If there is uncertainty which category should be assigned the lower of the two is default.
Suffixes to TNM
m = multiple primary tumors at a single site. it could also be indicated by the number of primary tumors.
Y = to indicate neo adjuvant therapy is being given prior to surgery with increasing frequency.
a = when stage is determined at autopsy.
r = when stage is determined after initial treatment at recurrence.
Additions to TNM
V = venous invasion.
O
V = can't be assessed.
8
X
V = no venous invasion.
0
o
V = venous invasion.
g
.
7
L = lymphatic invasion.
&
L = can't be assessed.
0
x
L = no lymphatic invasion.
00
L = lymphatic invasion.
01
Pn = perineural invasion
⑧
Pn = can't be assessed.
o
x
Pn = no perineural invasion.
g
O
Pn = perineural invasion.
·
1
⑧
R = after initial treatment (usually surgery) to describe extent of residual disease.
R = can't be assessed.
0
x
08R = no residual disease.
01R = microscopic residual disease.
R = gross residual disease.
·
2
Sentinel lymph node = first lymph node to receive drainage from primary tumor.
TNM-classification
·
-
Clinical classification (cTNM) Pathological classification (pTNM)
Designated before treatment to select and evaluate therapy. Designated after surgery to guide adjuvant therapy, estimate
-
prognosis and calculate end results.
T = extent of primary tumor.
T = primary tumor can't be assessed.
·
X
T = no evidence as primary tumor.
·
O
T = carcinoma in situ.
·
is
T - T = size and/or extent of primary tumor.
·
1 4 But evaluated histologically
N = extent of spread to lymph nodes.
N = regional lymph nodes can't be assessed.
·
X
·N = no regional lymph node involvement.
N - N = extend of spread to lymph nodes.
·
1 3
M = presence of metastasis to other parts of body.
M = no distant metastasis.
·
1M = distant metastasis.
If there is uncertainty which category should be assigned the lower of the two is default.
Suffixes to TNM
m = multiple primary tumors at a single site. it could also be indicated by the number of primary tumors.
Y = to indicate neo adjuvant therapy is being given prior to surgery with increasing frequency.
a = when stage is determined at autopsy.
r = when stage is determined after initial treatment at recurrence.
Additions to TNM
V = venous invasion.
O
V = can't be assessed.
8
X
V = no venous invasion.
0
o
V = venous invasion.
g
.
7
L = lymphatic invasion.
&
L = can't be assessed.
0
x
L = no lymphatic invasion.
00
L = lymphatic invasion.
01
Pn = perineural invasion
⑧
Pn = can't be assessed.
o
x
Pn = no perineural invasion.
g
O
Pn = perineural invasion.
·
1
⑧
R = after initial treatment (usually surgery) to describe extent of residual disease.
R = can't be assessed.
0
x
08R = no residual disease.
01R = microscopic residual disease.
R = gross residual disease.
·
2
Sentinel lymph node = first lymph node to receive drainage from primary tumor.
