The type of staging in colorectal cancer

The colorectal cancer can be staged in different ways. One of the most used classifications is the TNM classification. Generally after surgery the TNM classification is done and this is combined with other information in order to determine the cancer's stage.

In stage 0 (Tis, N0, M0) the cancer is in at the beginning and it has not developed beyond the colon's inner layer. Doctors refer to this stage as intramucosal carcinoma.

Stage I using the TNM classification can be T1, N0, M0, or T2, N0, M0, meaning that the cancer has reached the submucosa and might have also reached the muscularis propria. The lymph nodes are considered to be unaffected by cancer in this stage.

Stage II A meaning T3, N0, M0 refers to the fact that the cancer has spread into all the layers of the colon but has not reaches yet the lymph nodes nor other organs.

In stage II B the cancer has gone beyond the colon's layers and spread into the local area but the lymph nodes have not been affected yet.

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In stage IIIA (T1-2, N1, M0) the cancer has reached the submucosa and might have also reached the muscularis propria and it has definitely affected the local lymph nodes.

Stage III B refers to the T3-4, N1, M0, meaning that the cancer has spread into the layers of the colon and affected the local lymph nodes and the nearby tissues.

Stage III C refers to the fact that the cancer has spread to more than four lymph nodes but distant areas are clear.

Stage IV refers to Any T, Any N, M1 meaning that the cancer has spread in the body affecting other organs like the liver or affecting the peritoneum.

The staging will not be changes after treatment or in case the cancer comes back after several years. For example if one patient has been staged as N1 and the affected lymph nodes will be removed the classification will not be changed at N0. Even though the staging will not be changed, this does not mean that the doctors will be less careful when applying the treatment or that they will not be interested in your case any more.

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In patients who follow chemotherapy or radiotherapy, before surgery is done, in their medical chart will be added a note reflecting the previous staging and the following staging in order to help the doctor to choose the best therapy for the patient.