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    Rectal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Rectal Cancer

    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

    Stage T N M Dukesc MACc
    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.
    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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