Colon and rectum (ICD10 C18-C20)

This is the data sheet for TNM 9th edition staging of the colon and rectum (ICD10 C18-C20 - excluding C18.1)

For more detailed information regarding TNM staging, please see pages 75-78 of the UICC TNM 9 book.

T - primary tumour

Notes

^aTis includes cancer cells confined within the mucosal lamina propria (intramucosal) with no extension through the muscularis mucosae into the submucosa.

^bInvades through to visceral peritoneum to involve the surface

^cDirect invasion in T4b includes invasion of other organs or segments of the colorectum by way of the serosa, as confirmed on microscopic examination, or for tumours in a retroperitoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria.

^dTumour that is adherent to other organs or structures, macroscopically, is classified cT4b. However, if no tumour is present in the adhesion, microscopically, the classification should be pT1-3, depending on the anatomical depth of wall invasion.

N - regional lymph nodes

Notes:

Note * Tumour deposits (TDs) represent discrete tumour nodules of any shape, contour or size in peri-rectal and peri-colonic fat, away from the leading edge of the tumour, within the lymph drainage area of the primary carcinoma. TDs can originate from different histological structures, including lymph nodes, vessels and nerves. Therefore, TDs may contain foci of extramural vascular invasion (EMVI) and perineural invasion (PNI). The feature distinguishing a TD from EMVI and PNI is the presence of unequivocal tumour extension from the vessel or nerve into the surrounding fat or fibroconnective tissue. When tumour outgrowth from EMVI and/or PNI is present, the diagnosis of TDs and EMVI/PNI should be denoted separately in the report. If the tumour involves an identifiable lymph node, it is considered as lymph node metastasis and not as TDs even if the tumour extends into the perinodal fat

M - distant metastasis

pT - primary tumour

The pT and pN categories correspond to the cT and cN categories as per above.

pN - regional lymph nodes