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Stage Information for Rectal Cancer

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continued...

Table 2. Regional Lymph Nodes (N)a,b

^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 A satellite peritumoral nodule in the pericolorectal adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule may represent discontinuous spread, venous invasion with extravascular spread (V1/2), or a totally replaced lymph node (N1/2). Replaced nodes should be counted separately as positive nodes in the N category, whereas discontinuous spread or venous invasion should be classified and counted in the site-specific factor category Tumor Deposits.
NX	Regional lymph nodes cannot be assessed.
N0	No regional lymph node metastasis.
N1	Metastases in 1-3 regional lymph nodes.
N1a	Metastasis in 1 regional lymph node.
N1b	Metastases in 2-3 regional lymph nodes.
N1c	Tumor deposit(s) in the subserosa, mesentery, or nonperitonealized pericolic or perirectal tissues without regional nodal metastases.
N2	Metastases in ?4 regional lymph nodes.
N2a	Metastases in 4-6 regional lymph nodes.
N2b	Metastases in ?7 regional lymph nodes.

Table 3. Distant Metastasis (M)a

^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.
M0	No distant metastasis.
M1	Distant metastasis.
M1a	Metastasis confined to 1organ or site (e.g., liver, lung, ovary, nonregional node).
M1b	Metastases in >1 organ/site or the peritoneum.

Table 4. Anatomic Stage/Prognostic Groupsa,b

^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 cTNM is the clinical classification, and pTNM is the pathologic classification. The y prefix is used for those cancers that are classified after neoadjuvant pretreatment (e.g., ypTNM). Patients who have a complete pathologic response (ypT0, N0, cM0) may be similar to stage group 0 or I. The r prefix is to be used for those cancers that have recurred after a disease-free interval (rTNM).
^c Dukes B is a composite of better (T3, N0, M0) and worse (T4, N0, M0) prognostic groups, as is Dukes C (any T, N1, M0 and any T, N2, M0). MAC is the modified Astler-Coller classification.
Stage	T	N	M	Dukes^c	MAC^c
0	Tis	N0	M0	--	--
I	T1	N0	M0	A	A
�	T2	N0	M0	A	B1
IIA	T3	N0	M0	B	B2
IIB	T4a	N0	M0	B	B2
IIC	T4b	N0	M0	B	B3
IIIA	T1-T2	N1/N1c	M0	C	C1
�	T1	N2a	M0	C	C1
IIIB	T3-T4a	N1/N1c	M0	C	C2
�	T2-T3	N2a	M0	C	C1/C2
�	T1-T2	N2b	M0	C	C1
IIIC	T4a	N2a	M0	C	C2
�	T3-T4a	N2b	M0	C	C2
�	T4b	N1-N2	M0	C	C3
IVA	Any T	Any N	M1a	--	--
IVB	Any T	Any N	M1b	--	--

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Last Updated: May 16, 2012

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