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Cancer Health Center

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Gastrointestinal Carcinoid Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Gastrointestinal Carcinoid Tumors

Table 11. Anatomic Stage/Prognostic Groups for Stomach, Duodenum/Ampulla/Jejunum/Ileum, and Colon or Rectuma

Stage T N M
a Reprinted with permission from AJCC: Neuroendocrine tumors. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9.
0 Tis N0 M0
I T1 N0 M0
IIA T2 N0 M0
IIB T3 N0 M0
IIIA T4 N0 M0
IIIB Any T N1 M0
IV Any T Any N M1

Appendiceal Carcinoids

A new classification is added for carcinoid tumors that were not classified previously by TNM. This is a new classification. There are substantial differences between the classification schemes of appendiceal carcinomas and carcinoids and between appendiceal carcinoids and other well-differentiated gastrointestinal neuroendocrine tumors (carcinoids).[2]

Serum chromogranin A is identified as a significant prognostic factor.[2]

Table 12. Primary Tumor (T)a,b

a Reprinted with permission from AJCC: Appendix. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 133-41.
b Tumor that is adherent to other organs or structures, grossly, is classified cT4. However, if no tumor is present in the adhesion, microscopically, the classification should be classified pT1-3 depending on the anatomical depth of wall invasion.
c Penetration of the mesoappendix does not seem to be as important a prognostic factor as the size of the primary tumor and is not separately categorized.
TX Primary tumor cannot be assessed.
T0 No evidence of primary tumor.
T1 Tumor ≤2 cm in greatest dimension.
T1a Tumor ≤1 cm in greatest dimension.
T1b Tumor >1 cm but not >2 cm.
T2 Tumor >2cm but not >4 cm or with extension to the cecum.
T3 Tumor >4 cm or with extension to the ileum.
T4 Tumor directly invades other adjacent organs or structures, e.g., abdominal wall and skeletal muscle.c

Table 13. Regional Lymph Nodes (N)a

a Reprinted with permission from AJCC: Appendix. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 133-41.
NX Regional lymph nodes cannot be assessed.
N0 No regional lymph node metastasis.
N1 Regional lymph node metastasis.
1 | 2 | 3 | 4
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