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Colorectal Cancer Health Center

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Stage Information for Rectal Cancer

    Table 1. Primary Tumora

    a Reprinted with permission from AJCC: Colon and rectum. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 143-164.
    b Tis includes cancer cells confined within the glandular basement membrane (intraepithelial) or mucosal lamina propria (intramucosal) with no extension through the muscularis mucosae into the submucosa.
    c Direct invasion in T4 includes invasion of other organs or other segments of the colorectum as a result of direct extension through the serosa, as confirmed on microscopic examination (e.g., invasion of the sigmoid colon by a carcinoma of the cecum) or, for cancers in a retroperitoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria (i.e., respectively, a tumor on the posterior wall of the descending colon invading the left kidney or lateral abdominal wall; or a mid or distal rectal cancer with invasion of prostate, seminal vesicles, cervix, or vagina).
    d Tumor that is adherent to other organs or structures, grossly, is classified cT4b. However, if no tumor is present in the adhesion, microscopically, the classification should be pT1–4a depending on the anatomical depth of wall invasion. The V and L classifications should be used to identify the presence or absence of vascular or lymphatic invasion, whereas the PN site-specific factor should be used for perineural invasion.
    TXPrimary tumor cannot be assessed.
    T0No evidence of primary tumor.
    TisCarcinomain situ: intraepithelial or invasion of lamina propria.b
    T1Tumor invades submucosa.
    T2Tumor invades muscularis propria.
    T3Tumor invades through the muscularis propria into pericolorectal tissues.
    T4aTumor penetrates to the surface of the visceral peritoneum.c
    T4bTumor directly invades or is adherent to other organs or structures.c,d
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