Digestive System Tumours

TNM 7 Classification

The following sites are included:

• Oesophagus
• Stomach
• Small Intestine
• Appendix - Carcinoma and Carcinoid Tumours
• Colon and Rectum
• Anal Canal
• Gastrointestinal Stromal Tumour (GIST)
• Gastric, Small & Large Intestinal Carcinoid Tumours
• Liver and Intrahepatic Bile Ducts
• Gallbladder
• Extrahepatic Bile Ducts - Distal and Perihilar
• Ampulla of Vater
• Pancreas

TNM 6 Classification

1. Introductory Notes

The following sites are included:

• Oesophagus
• Stomach
• Small Intestine
• Colon and Rectum
• Anal Canal
• Liver and Intrahepatic Bile Ducts
• Gallbladder
• Extrahepatic Bile Ducts
• Ampulla of Vater
• Pancreas

Each site is described under the following headings:

• Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment
• Anatomical sites and subsites where appropriate
• Definition of the regional lymph nodes
• TNM Clinical classification
• pTNM Pathological Classification
• G Histopathological grading
• Stage grouping
• Summary
  
  

2. Regional Lymph Nodes

The number of lymph nodes ordinarily included in a lymphadenectomy specimen is noted at each site.

3. Distant Metastasis

The categories M1 and pM1 may be further specified according to the following notation:

Pulmonary PUL Bone marrow MAR Osseous OSS Pleura PLE Hepatic HEP Peritoneum PER Brain BRA Adrenals ADR Lymph nodes LYM Skin SKI Others OTH

4. Histopathological Grading

The definitions of the G categories apply to all digestive system tumours except liver. These are:

G - Histopathological Grading

GX. Grade of differentiation cannot be assessed
G1. Well differentiated
G2. Moderately differentiated
G3. Poorly differentiated
G4. Undifferentiated

5. R Classification

The absence or presence of residual tumour after treatment is described by the symbol R. The definitions of the R classification apply to all digestive system tumours. These are:

RX. Presence of residual tumour cannot be assessed
R0. No residual tumour
R1. Microscopic residual tumour
R2. Macroscopic residual tumour