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Stage Information for Gastrointestinal Carcinoid Tumors

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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.

Table 14. Distant Metastasisa

^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.
M0	No distant metastasis.
M1	Distant metastasis.

pTNM Pathologic Classification. The pT, pN, and pM categories correspond to the T, N, and M categories except that pM0 does not exist as a category.[2]

pN0. Histological examination of a regional lymphadenectomy specimen will ordinarily include 12 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0.[2]

Table 15. Anatomic Stage/Prognostic Groupsa

^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.
Carcinoid
Stage	T	N	M
I	T1	N0	M0
II	T2, T3	N0	M0
III	T4	N0	M0
Any T	N1	M0
IV	Any T	Any N	M1

Carcinoid. Histologic grading is not carried out for carcinoid tumors, but a mitotic count of 2-10 per 10 hpf and/or focal necrosis are features of atypical carcinoids (well-differentiated neuroendocrine carcinomas), a type seen much more commonly in the lung than in the appendix.[2]

Goblet cell carcinoids are classified according to the carcinoma scheme.[2]

This staging classification applies to carcinoids that arise in the appendix. The histologic types include the following:[2]

Carcinoid tumor.
Well-differentiated neuroendocrine tumor.
Tubular carcinoid.
Goblet cell carcinoid.
Adenocarcinoid.
Atypical carcinoid.

Well-differentiated neuroendocrine carcinoma after resection (relevant to resection margins that are macroscopically involved by tumor).[2]

Table 16. Residual Tumor (R)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.
Carcinoma and Carcinoid
R0	Complete resection, margins histologically negative; no residual tumor left after resection.
R1	Incomplete resection, margins histologically involved, microscopic tumor remains after resection of gross disease (relevant to resection margins that are microscopically involved by tumor).
R2	Incomplete resection, margins involved or gross disease remains.

References:

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.
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.

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Last Updated: May 16, 2012

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