Lecture notes for medical students

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3. First show the blank slides (eg. Aetiology ) > Ask
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aetiologies.
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5. This will be an ACTIVE LEARNING SESSION x
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6. Good for self study also.
7. See notes for bibliography.

2. TNM Classification

3. TNM Classification
• T

4. TNM Classification
• TX -
• T0 -
• Tis -
• T1 -
• T2 -
• T3 -
• T4 -

5. TNM Classification
• TX - Primary tumor cannot be assessed or depth of
penetration not specified
• T0 - No evidence of primary tumor
• Tis - Carcinoma in situ (mucosal); intraepithelial or
invasion of the lamina propria
• T1 - Tumor invades submucosa
• T2 - Tumor invades muscularis propria
• T3 - Tumor invades through the muscularis propria into
the subserosa or into non-peritonealized pericolic or
perirectal tissue
• T4 - Tumor directly invades other organs or structures
and/or perforates the visceral peritoneum

6. TNM Classification
• N- Regional lymph nodes

7. TNM Classification
N- Regional lymph nodes
• NX -
• N0 -
• N1 -
• N2
• N3

8. TNM Classification
N- Regional lymph nodes
• NX - Regional lymph nodes cannot be
assessed
• N0 - No regional lymph node metastasis
• N1 - Metastasis in 1-3 pericolic or perirectal
lymph nodes
• N2 - Metastasis in 4 or more pericolic or
perirectal lymph nodes
• N3 - Metastasis in any lymph node along
the course of a named vascular trunk

9. TNM Classification
M- Metastasis-
• MX -
• M0 -
• M1 -

10. TNM Classification
M- Metastasis-
• MX - Presence of metastasis cannot be
assessed
• M0 - No distant metastasis
• M1 - Distant metastasis

11. TNM Classification
• Stage I -T1-2 N0 M0
• Stage II
• A-T3 N0 M0
• B-T4 N0 M0
• Stage III
• A- T1-2 N1 M0
• B-T3-4 N1 M0
• C-T1-4 N2 M0
• Stage IV
• T1-4 N0-2 M1

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