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223 Cards in this Set
- Front
- Back
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Endometrial FIGO Stages
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IA, IB, II, IIIA, IIIB, IVA, IVB
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Define endometrial stage IA
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Tumor limited to endometrium or invades < 1/2 of the myometrium
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Define endometrial stage IB
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Tumor invasion one half or more of the myometrium
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Define endometrial stage II
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Invades stromal connective tissue of the cervix but does not extend beyond the uterus
Endocervical glandular involvement alone is considered stage I, not stage II |
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Define endometrial stage IIIA
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Tumor invades serosa and/or adnexa (direct extension or metastasis)
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Define endometrial stage IIIB
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Vaginal involvement (direct extension or metastasis) or parametrial involvement
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Define endometrial stage IIIC1 and IIIC2
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Stage IIIC1: Pelvic LN metastases
Stage IIIC2: Paraaortic LN mets with or without pelvic LN metastates |
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Define endometrial stage IVA
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Tumor invades the bladder and/or bowel mucosa
Bullous edema is not sufficient to classify a tumor as T4 |
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Define endometrial stage IVB
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Distant metastases
- Including intraperitoneal disease and/or metastases to inguinal LN, lung, liver, or bone - Excludes metastases to PA LN, vagina, pelvis serosa, or adnexa |
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Endometrial cancer grades
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% non-squamous or non-morular solid growth pattern
Note 1 Notable nuclear atypia, inappropriate for the architectural grade, raises the grade by one 2 Serous, clear cell, and mixed mesodermal tumors are Grade 3 |
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Define endometrial grade 1
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<= 5% of a nonsquamous or nonmorular solid growth pattern
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Define endometrial grade 2
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6-50% of a nonsquamous or nonmorular solid growth pattern
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Define endometrial grade 3
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> 50% of a nonsquamous or nonmorular solid growth pattern
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Cervical FIGO Stages
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0,
IA1, IA2, IB1, IB2, IIA1, IIA2 IIB, IIIA, IIIB, IVA, IVB |
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Define cervical stage I
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Carcinoma strictly confined to the cervix
(Extension to the corpus should be disregarded.) |
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Define cervical stage IA1 and IA2
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Invasive cancer identified only microscopically.
All macroscopically visible lesions -- even with superficial invasion -- are stage IB cancers. Invasion is limited to measured stromal invasion IA1 - Maximum depth of 3.0 mm or less - Horizontal spread 7.0 mm or less IA2 - Stromal invasion at least 3.0 mm but not more than 5.0 mm - Horizontal spread 7.0 mm or less |
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Define cervical stage IA1
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Measured invasion of stroma <= 3.0 mm in depth and no wider than 7.0 mm
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Define cervical stage IA2
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Measured invasion of stroma > 3.0 mm and <= 5.0 mm and no wider than 7.0 mm
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Define cervical stage IB
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Clinical lesions confined to the cervix or preclinical lesions greater than stage IA
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Define cervical stage IB1
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Clinical lesions no greater than 4.0 cm
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Define cervical stage IB2
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Clinical lesions greater than 4.0 cm
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Define cervical stage II
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Invades beyond the cervix but not to pelvic wall or lower third of the vagina
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Define cervical stage IIA
IIA1 IIA2 |
No obvious parametrial involvement
IIA1: Clinically visible lesion 4.0 cm or less IIA2: Clinically visible lesion more than 4.0 cm |
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Define cervical stage IIB
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Parametrial invasion
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Define cervical stage III
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Involves the lower third of the vagina and/or
Extends to the pelvic wall and/or (No cancer-free space between the tumor and pelvic wall on rectal exam) Causes hydronephrosis |
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Define cervival stage IIIA
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Involves lower third of the vagina
No extension to the pelvic wall |
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Define cervical stage IIIB
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Extends to the pelvic wall (T3b) and/or
Causes hydronephrosis or nonfunctioning kidney (T3b) and/or Involves regional LN (N1) |
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Define cervical stage IVA
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Invades mucosa of bladder or rectum and/or
Extends beyond the true pelvis (Bullous edema is not sufficient to classify a tumor as T4) |
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Define cervical stage IVB
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Distant metastasis
1 Peritoneal spread and/or 2 SCV or mediastinal nodes and/or 3 Lung, liver, or bone |
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Ovarian FIGO Stages
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I: IA, IB, IC
II: IIA, IIB, IIC III: IIIA, IIIB, IIIC IV |
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Define ovarian stage I
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Growth limited to the ovaries
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Define ovarian stage IA
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Growth limited to one ovary
No ascites No tumor on the external surfaces Capsule intact |
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Define ovarian stage IB
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Growth limited to both ovaries
No ascites No tumor on the external surfaces Capsule intact |
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Define ovarian stage IC
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Tumor either stage IA or IB but on the surface of one or both ovaries
Capsule ruptured Ascites containing malignant cells present Positive peritoneal washings |
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Define ovarian stage II
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Growth involving one or both ovaries with pelvic extension of disease
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Define ovarian stage IIA
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Extension of disease and/or mets to the uterus and/or fallopian tubes
No malignant cells in ascites or washings |
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Define ovarian stage IIB
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Extension to and/or implants on other pelvic tissues
No malignant cells in ascites or washings |
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Define ovarian stage IIC
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Pelvis extension or implants (T2a or T2b) with malignant cells in ascites or washings
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Define ovarian stage III
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Tumor involving one or both ovaries with peritoneal implants outisde the pelvis and/or positive retroperitoneal or inguinal nodes
Superficial liver mets equals stage III Tumor is limited to the true pelvis but with histologically verified malignant extension to the small bowel or omentum |
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Define ovarian stage IIIA
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Microscopic peritoneal mets beyond pelvis but no macroscopic tumor
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Define ovarian stage IIIB
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Macroscopic peritoneal mets beyond pelvis not more than 2 cm in greatest dimension
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Define ovarian stage IIIC
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Abdominal implants > 2 cm and/or positive regional lymph nodes
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Define ovarian stage IV
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Distant mets excluding peritoneal mets
If pleural effusion is present, there must be positive cytologic test results to allot a case to stage IV. Parenchymal liver mets |
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List prostate cancer stages
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T1a, T1b, T1c
T2a, T2b, T2c T3a, T3b T4 N1 M1 |
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Define prostate stage T1a
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Tumor incidental histologic finding in ≤ 5% of resected tissue
Not palpable |
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Define prostate stage T1b
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Tumor incidental histologic finding in > 5% of resected tissue
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Define prostate stage T1c
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Tumor identified by needle biopsy (eg, because of elevated PSA level)
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Define prostate stage T2a
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Tumor involves ≤ one-half of one lobe
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Define prostate stage T2b
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Tumor involves > one-half of one lobe but not both lobes
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Define prostate stage T2c
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Tumor involves both lobes
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Define prostate stage T3a
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Extracapsular extension (unilateral or bilateral)
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Define prostate stage T3b
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Tumor invades seminal vesicle(s)
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Define prostate stage T4
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Fixed to pelvic side wall
Invades adjacent structures other than seminal vesicles: - Bladder neck - External sphincter - Rectum - Levator muscles - Pelvis wall |
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Define prostate stage N1
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Positive regional lymph nodes
- Pelvic - Hypogastric - Obturator - Iliac (internal or external) - Sacral -- Lateral -- Presacral -- Promontory (Gerota's) |
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Define prostate stage M1
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Distant metastasis
M1a - Non-regional nodes M1b - Bone M1c - Other sites |
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List stages of vulvar cancer
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T: X, 0, is, 1, 1a, 1b, 2, 3, 4
N: X, 0, 1, 2 M: X, 0, 1 |
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Define vulvar stage TX
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Primary tumor cannot be assessed
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Define vulvar stage T0
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No evidence of primary tumor
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Define vulvar stage Tis
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Carcinoma in situ
(preinvasive carcinoma) |
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Define T1
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Tumor confined to the vulva or vulva and perineum
2 cm or less in greatest dimension |
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Defeine vulvar stage T1a/IA
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Tumor confined to the vulva or vulva and perineum
2 cm or less in greatest dimension Stromal invasion ≤ 1 mm |
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Define vulvar stage T1b/IB
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Tumor confined to the vulva or vulva and perineum
≤ 2 cm in greatest dimension Stromal invasion > 1 mm |
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Define vulvar stage T2/II
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Tumor of any size with extension to adj perineal structures
- Distal 1/3 of urethra - Distal 1/3 of vagina - Anal involvement TNM uses T2 while FIGO calls this T2/3 |
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Define vulvar stage T3/IVA
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Tumor of any size with extension to any of the following
- Proximal 2/3 of urethra - Proximal 2/3 of vagina - Bladder mucosa - Rectal mucosa - Fixed to pelvic bone TNM uses T3 while FIGO calls this T4 |
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Define vulvar stage T4
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Tumor invades any of the following:
Upper urethral mucosa Bladder mucosa Rectal mucos Fixed to the pubic bone |
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Define vulvar stage N1/FIGO IIIA
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N1a/FIGO IIIA One or two LN mets each no more than 5 mm
N1b/FIGO IIIA One LN met more than 5 mm |
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Define vulvar stage N2/FIGO IIIB
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N2a/FIGO IIIB Three or more LN mets no greater than 5 mm
N2b/FIGO IIIB Two or more LN mets greater than 5 mm N2c/FIGO IIIC LN mets with ECE |
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List vulvar M stages
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X, 0, 1
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Define vulvar stage MX
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Distant mets cannot be assessed
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Define vulvar stage M1
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Distant mets including pelvic lymph node mets
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List the vulvar FIGO stage grouping
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Stage 0, IA, IB, II, III, IVA, IVB
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Define vulvar FIGO stage 0
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Tis N0 M0
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Define vulvar FIGO stage IA
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T1a N0 M0
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Define vulvar FIGO stage IB
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T1b N0 M0
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Define vulvar FIGO stage II
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T2 N0 M0
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Define vulvar FIGO stage IIIA
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T1-2 N1a-N1b M0
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Define vulvar FIGO stage IVA
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T1 N2 M0
T2 N2 M0 T3 N2 M0 T4 Any N M0 |
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Define vulvar FIGO stage IVB
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Any T Any N M1
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Basic Concepts of STS Staging
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AJCC staging system
-Unique among AJCC staging systems -High importance of grade for prognosis -Three prognostic factors 1 Tumor size 2 Tumor grade 3 Tumor depth |
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STS TNM
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TX Cannot be assessed
T0 No evidence of primary T1 ≤5 cm --T1a Superficial tumor --T1b Deep tumor T2 >5 cm --T2a Superficial tumor --T2b Deep tumor N1 Regional LN mets M1 Distant mets |
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STS Histopathologic grade
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GX Grade cannot be assessed
G1 Well differentiated G2 Moderately differentiated G3 Poorly differentiated G4 Undifferentiated |
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STS Stage grouping
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Stage I
A G1-2 T1a-1b N0 M0 B G1-2 T2a N0 M0 Stage II A G1-2 T2b N0 M0 B G3-4 T1a-1b N0 M0 C G3-4 T2a N0 M0 Stage III G3-4 T2b N0 M0 Stage IV -Any G Any T N1 M0 -Any G Any T N0 M1 |
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Malignancy Group by Type of STS
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Group 1
- Locally recurring neoplasms - Little or no metastatic potential Group 2 -Sarcomas of intermediate agressiveness -But with metastatic capability Group 3 - Aggressive sarcomas |
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Breast T1
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T1mic Microinvasion ≤ 0.1 cm
T1a > 0.1 but ≤ 0.5 cm T1b > 0.5 but ≤ 1 cm T1c > 1 but ≤ 2 cm |
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Breast T2
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> 2 but ≤ 5 cm
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Breast T3
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> 5 cm
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Breast T4
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T4a Extension to chest wall not including pectoralis
T4b - Edema (peau d'orange) or ulceration of skin - Satellite skin nodules confined to same breast T4c Both T4a and T4b T4d Inflammatory carcinoma |
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Breast N1
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Mets to movable ipsi axillary nodes
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Breast N2
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N2a Mets in ipsi axillary nodes fixed or matted
N2b Mets in CA ipsi internal mammary nodes without CA axillary nodes |
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Breast N3
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N3a Mets in ipsi infraclavicular nodes
N3b Mets in ipsi internal mammary and axillary nodes N3c Mets in ipsi supraclvicular nodes |
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Breast pN1
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pN1mi
> 0.2 mm but ≤ 2.0 mm In 1-3 axillary nodes and/or IMNs by SLND not CA pN1a Met in 1-3 axillary nodes pN1b Mets in IMNs by SLND not CA |
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Breast N2
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N2a Mets in 4-9 axillary nodes
N2b Mets in CA IMNs without axillary nodes |
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Breast N3
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N3a Mets in ≥ 10 axillary nodes or mets to the infraclavicular nodes
N2b Mets in CA ipsi IMNs in the presence of ≥ 1 positive axillary nodes; in > 3 axillary nodes and in IMNs with microscopic disease by SLND but not CA pN3c Mets in ipsilateral supraclavicular nodes |
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Breast Stage I
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T1N0M0
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Breast Stage IIA
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T0-1 N1 M0
T2 N0 M0 |
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Breast Stage IIB
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T2 N1 M0
T3 N0 M0 |
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Breast Stage IIIA
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T0-2 N2 M0
T3 N1-2 M0 |
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Breast Stage IIIB
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T4 N0-2 M0
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Breast Stage IIIC
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Any T N3 Mo
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Breast Stage IV
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Any T Any N M1
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Breast disease: multicentricity
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Lesions in different quadrants --> mastectomy
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Breast disease: multifocality
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Lesions in same quadrant --> still option for BCT
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Colon and Rectum T Stage
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T1 Invades submucosa
T2 Invades muscularis propria T3 Invades through muscularis propria into subserosa or into non-peritonealized pericolic or perirectal tissues T4 Directly invades other organs or structures and/or perforaes visceral peritoneum |
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Colon and Rectum N Stage
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N1 Mets in 1 to 3 regional nodes
N2 Mets in 4 or more regional nodes |
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Colon and Rectum M Stage
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M1 Distant mets
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Colon and Rectum Staging Grouping (Dukes)
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I: T1N0M0, T2N0M0 (A)
IIA: T3N0M0 (B) IIB: T4N0M0 (B) IIIA: T1N1M0, T2N1M0 (C) IIIB: T3N1M0, T4N1M0 (C) IIIC: Any T N2M0 (C) IV: Any T Any N M1 |
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Immunophenotyping: CD45
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All lymphoid cells
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Immunophenotyping: CD19, CD 20, CD 22
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B-cells
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Immunophenotyping: CD2, CD3, CD 5, CD7
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T-cells
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Immunophenotyping
- CD4 - CD8 |
CD4: Helper T cells
CD8: Cytotoxic cells |
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Immunophenotyping: CD16, CD56, CD57
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Natural killer cells
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Immunophenotyping: CD5-, CD10+, CD43-
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Follicular cell lymphoma
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Immunophenotyping: CD5+, CD10+, CD43-
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Mantle cell lymphoma
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Immunophenotyping: CD5-, CD10-, CD23-
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MALT lymphoma
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Immunophenotyping: CD15+, CD30+
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Hodgkin's disease
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Cytogenetics: Alveolar rhabdomyosarcoma
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T(2:13) and T(1:13)
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Cytogenetics: Burkitt's lymphoma and B-cell ALL (c-myc gene)
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t(8:14) and t(8:22)
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Cytogenetics: Mantle cell lymphoma
(bcl-1 gene, cyclin D1 over expression) |
t(11:14)
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Cytogenetics: Ewing's sarcoma & PPNET
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t(11:22)
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Cytogenetics: Clear cell sarcoma
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t(12:22)
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Cytogenetics: Follicular lymphoma and diffuse large B-cell lymphoma (BCL-2 gene)
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t(14:18)
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Cytogenetics: CLL (BCL-3 gene)
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t(14:19)
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Cytogenetics: Synovical cell sarcoma
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t(X:18)
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Staging: Urethra - T Stages
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Staging: Urethra - T Stages
T1 - Subepithelial tissue T2 - Corpus spongiosum - Prostate - Periurethral muscle T3 - Corpus cavernosum - Beyond prostate capsule - Anterior vagina - Bladder neck T4 - Other adjacent organs |
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Staging: Urethra - N Stages
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Staging: Urethra - N Stages
N1 - Single node ≤ 2cm N2 - Single node > 2cm - Multiple nodes |
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Staging: Urethra - M Stages
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Staging: Urethra - M Stages
M0 - No distant mets M1 - Distant mets |
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Staging: Urethra - Group stages
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Staging: Urethra - Group stages
I - T1N0M0 II - T2N0M0 III - T1N1, T2N1, T3N0, T3N1 IV - T4N0, T4N1, TxN2, TxNxM1 |
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Staging: Urothelial (transitional cell) carcinoma of the prostate - T Stages
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Staging: Urothelial (transitional cell) carcinoma of the prostate - T Stages
Tis pu - Cis prostatic urethra Tis pd - Cis prostatic ducts T1 - Subepithelial connective tissue T2 - Prostatic stroma - Corpus spongiosum - Periurethral muscle T3 - Corpus cavernosum - Beyond prostatic capsule - Bladder neck (extraprostatic extension) T4 - Other adjacent organs (bladder) |
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Staging: Urothelial (transitional cell) carcinoma of the prostate - N Stages
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Staging: Urothelial (transitional cell) carcinoma of the prostate - N Stages
N1 Single node ≤ 2cm N2 - Single node > 2cm - Multiple nodes |
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Staging: Urothelial (transitional cell) carcinoma of the prostate - M Stages
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Staging: Urothelial (transitional cell) carcinoma of the prostate - M Stages
M0 No distant mets M1 Distant mets |
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Staging: Urothelial (transitional cell) carcinoma of the prostate - Stage groups
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Staging: Urothelial (transitional cell) carcinoma of the prostate - Stage groups
I: T1N0M0 II: T2N0M0 III - T1N1M0 - T2N1M0 - T3N0M0 - T3N1M0 IV - T4N0M0 - T4N1M0 - TxN2M0 - TxNxM1 |
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Staging: Bladder - T Stages
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Staging: Bladder - T Stages
Tis - Flat tumor T1 - Subepithelial connective tissue T2a - Invades superficial (inner half) muscle T2b - Invades deep (outer half) muscle T3a - Microscopic perivesical tissue T3b - Macroscopic pervesical tissue (extravesical mass) T4a - Prostate, uterus, vagina T4b - Pelvic wall, abd wall |
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Staging: Bladder - N Stages
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Staging: Bladder - N Stages
N1: Single node ≤ 2 cm N2 - Single node > 2 cm but ≤ 5 cm - Multiple nodes ≤ 5cm N3: > 5cm |
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Staging: Bladder - M Stages
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Staging: Bladder - M Stages
M0 - No distant mets M1 - Distant mets |
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Staging: Bladder - Group stages
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Staging: Bladder - Group stages
I: T1N0M0 II: T2a/bN0M0 III: T3a/bN0M0, T4aN0M0 IV - T4bN0M0 - AnyT N1-3 M0 - AnyT AnyN M1 |
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Staging: Testis - pT stages
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Staging: Testis - pT stages
pTis - Intratubular germ cell neoplasia pT1 - Testis and epididymis without LVSI - Tunica albuginea but not vaginalis pT2 - Testis and epididymis with LVSI - Tunica albuginea and vaginalis pT3 - Spermatic cord +/- LVSI pT4 - Scrotum +/- LVSI |
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Staging: Testis - pN stages
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Staging: Testis - N stages
pN1 ≤ 2cm and ≤ 5 pos nodes pN2 - > 2 but ≤ 5 cm - > 5 pos nodes ≤ 5cm - ECE pN3 > 5cm |
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Staging: Testis - cN stages
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Staging: Testis - cN stages
cN1 - Single <= 2cm - Multiple <= 2cm cN2 - Single 2-5 cm - Multiple with one 2-5cm cN3 - > 5cm |
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Staging: Testis - M stages
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Staging: Testis - M stages
M0 - No distant mets M1a - Non-regional nodal or pulm mets M1b - Distant mets other than non-regional and pulm |
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Staging: Testis - S stages
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Staging: Testis - S stages
S0 - Markers normal S1 - LDH < 1.5N AND hCG < 5000mIu/ml AND AFP < 1000ng/ml S2 - LDH 1.5-10N OR hCG 5000-50,000mIu/ml OR AFP 1000-10,000ng/ml S3 - LDH > 10N OR hCG > 50,000mIu/ml OR AFP > 10,000ng/ml |
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Staging: Testis - Groups stages IA
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Staging: Testis - Groups stages IA
IA: pT1N0M0S0 IB: pT2-4N0M0S0 IS: pTxN0M0S1-3 IIA: pTxN1M0S0-1 IIB: pTxN2M0S0-1 IIC: pTxN3M0S0-1 IIIA: pTxNxM1aS0-1 IIIB: pTxNxM0S2 or pTxNxM1aS2 IVA: pTxNxM0S3 or pTxNxM1aS3 or pTxNXM1bSx |
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Staging: Esophagus - T stages
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Staging: Esophagus - T stages
T1 - Lamina propria or submucosa T2 - Muscularis propria T3 - Adventitia T4 - Adjacent structures |
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Staging: Esophagus - N stages
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Staging: Esophagus - N stages
N0 - No regional nodes N1 - Regional nodes |
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Staging: Esophagus - M stages
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Staging: Esophagus - M stages
Lower thoracic esophagus M1a - Mets in celiac nodes M1b - Other distant mets Midthoracic esophagus M1a - Not applicable M1b - Nonregional nodes or distant mets Upper thoracic esophagus M1a - Mets in cervical nodes M1b - Other distant mets |
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Staging: Esophagus - Stage groups
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Staging: Esophagus - Stage groups
I: T1N0M0 IIA: T2N0M0, T3N0M0 IIB: T1N1M0, T2N1M0 III: T3N1M0, T4NxM0 IVA: TxNxM1a IVB: TxNxM1b |
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Staging: Esophagus - Regional nodes
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Staging: Esophagus - Regional nodes
Cervical esophagus - Scalene, IJ, cervical - Periesophageal, supraclav Intrathoracic (upper, mid, lower) - Upper periesophageal (above azygous) - Subcarinal, lower periesoph GE junction - Lower esoph, diaphragmatic - Pericardial, left gastric, celiac |
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Staging: Penis - T stages
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Staging: Penis - T stages
T1 - Subepithelial connective tissue T2 - Corpus spongiosum or cavernosum T3 - Urethral or prostate T4 - Adjacent strucles |
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Staging: Penis - N stages
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Staging: Penis - N stages
N1 - Single superficial inguinal node N2 - Multiple superficial inguinal nodes ipsi or bilateral N3 - Deep inguinal or pelvic lymph nodes uni- or bilateral |
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Staging: Penis - M stages
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Staging: Penis - M stages
M0 No distant mets M1 Distant mets |
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Staging: Anal T Stages
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Staging: Anal T Stages
T1 ≤ 2 cm T2 > 2 cm but ≤ 5cm T3 > 5cm T4: Adj organs - Vagina - Urethra - Bladder Direct invasion of rectall wall, perirectal skin, subcu tissue, or sphincter is not T4. |
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Staging: Anal N Stages
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Staging: Anal N Stages
N1: Perirectal lymph nodes N2 - Unilateral internal iliac nodes - Unilateral inguinal nodes N3 - Perirectal and inguinal nodes - Bilateral internal iliac nodes - Bilateral inguinal nodes |
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Staging: Anal M Stages
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Staging: Anal M Stages
M1: Distant mets |
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Staging: Anal Group Staging
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Staging: Anal Group Staging
I: T1N0M0 II: T2N0M0, T3N0M0 IIIA: T1N1M0, T2N1M0,T3N1M0,T4N0M0 IIIB: T4N1M0,TxN2M0,TxN3M0 IV: TxNxM1 |
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Basic Concepts of STS Staging
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Applies to all STS except
1 Kaposi's sarcoma 2 Dermatofibrosarcoma protuberans 3 Desmoid tumor 4 Sarcoma arising within the dura mater including the brain 5 Sarcomas arising within parenchymatous organs or hollow viscera Depth defined in relation to superficial muscular fascia If tumor involves superficial muscular fascia and retroperitoneal regions = deep |
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Vagina T1
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Confined to vagina
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Vagina T2
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Invades paravaginal tissues but not to pelvic wall
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Vagina T3
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Extends to pelvic wall
Pelvic wall - Muscle - Fascia - Neurovascular structures - Skeletal portion of bony pelvis |
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Vagina T4
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Invades rectal/bladder mucosa and/or
Extends beyond true pelvis |
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Vagina N1
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Pelvic or inguinal lymph node mets
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Vagina M1
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Distant mets
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Vagina FIGO Stages
I II III IVA IVB |
Vagina FIGO Stages
I: T1N0M0 II: T2N0M0 III: T3N0M0, T1-3N1 IVA: T4 AnyN M0 IVB: AnyT AnyN M1 |
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Define prostate histologies
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Define prostate histologies
- Adenocarcinoma - Squamous carcinomas Not - Sarcoma - Transitional cell carcinoma = urethral tumor |
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Define prostate grades
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Define prostate grades
G1: Well diff (Gleason 2-4) G2: Mod diff (Gleason 5-6) G3-4: Poorly diff/Undiff (Gleason 7-10) |
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Staging: Penis - Group Stages
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Staging: Penis - Group Stages
I: T1N0M0 II: T1N1M0, T2N0-1M0 III: T1-2N2M0, T3N0-2M0 IV: T4 Any N M0, Any T N3 M0, Any T Any N M1 |
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Stomach T Staging
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T1: Lamina propria or submucosa
T2a: Muscularis propria T2b: Subserosa T3: Penetrates serosa without invasion of adj structures T4: Adj structures |
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Stomach N Staging
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N1: 1-6 regional nodes
N2: 7-15 regional nodes N3: > 15 regional nodes |
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Not Stomach Regional Nodes = Distant Mets
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Hepatoduodenal
Retropancreatic Mesenteric Para-aortic |
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Stomach Stage Grouping
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IA: T1N0M0
IB: T1N1M0, T2a/bN0M0 II: T1N2M0, T2a/bN1M0, T3N0M0 IIIA: T2a/bN2M0, T3N1M0, T4N0M0 IIIB: T3N2M0 IV: T4N1-3M0, T1-3N3M0, TxNxM1 |
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Small Intestine T Staging
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T1: Lamina propria or submucosa
T2: Muscularis propria T3: Penetrates muscularis propria - Into subserosa - Into nonperitonealized perimuscular tissues (mesentery or retroperitoneum) ≤ 2 cm T4: Perforates visceral peritoneum Directly invades other organs or structures -- Other loops of small intestine -- Mesentery -- Retroperitoneum > 2 cm -- Abdominal wall -- Pancreas (for duodenum only) |
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Small Intestine N Staging
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N1: Regional nodes
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Small Intestine Group Staging
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I: T1-2N0M0
II: T3-4N0M0 III: TxN1M0 IV: TxNXM1 |
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Colorectal T Staging
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T1: Submucosa
T2: Muscularis propria T3 - Through muscular into subserosa - Into non-peritonealized pericolic or perirectal tissues T4 - Other organs or structures - Perforates visercal peritoneum |
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Colorectal N Staging
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N1: 1-3 regional nodes
N2: > 3 regional ndoes |
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Colorectal Dukes Staging
A B C |
A: I
B: IIA and IIB C: IIIA, IIIB, IIIC |
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Colorectal R Staging
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R0
- Complete resection - Margins histologically negative - No residual tumor R1 - Incomplete resection - Margins histologically involved - Microscopic residual tumor R2 - Incomplete resection - Margins involved - Gross residual disease |
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Liver T Staging
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T1: Solitary with VI
T2 - Solitary with VI - Multiple tumors ≤ 5 cm T3 - Multiple tumors > 5 cm OR - Involving major branch of portal or hepatic veins T4 - Direct invasion of adj organs other than GB OR - Perforation of visceral peritoneum |
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Liver N Staging
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N1: Regional nodes
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Liver Stage Grouping
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I: T1N0M0
II: T2N0M0 IIIA: T3N0M0 IIIB: T4N0M0 IIIC: TxN1M0 IV: TxNxM1 |
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Gallbladder T Staging
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T1a: Lamino propria
T1b: Muscle layer T2 - Perimuscular connective tissue - No extension beyond serosa or into liver T3 - Perforates seros - Invades liver or adj organ T4 - Invades main portal vein or hepatic artery - Invades ≥ 2 extrahepatic organs |
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Gallbladder N Staging
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N1: Regional nodes
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Extrahepatic Bile Duct T Staging
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T1: Bile duct only
T2: Wall of duct T3 - Liver, GB, or pancreas - Ipsi branches of portal vein or hepatic artery T4 - Main portal vein or branches bilaterally - Common hepatic artery - Adj structures -- Colon -- Stomach -- Duodenum -- Abdominal wall |
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Extrahepatic Bile Duct N Staging
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N1: Regional nodes
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Ampulla T Staging
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T1: Ltd to ampulla or Oddi
T2: Duodenal wall T3: Pancreas T4: Peripan soft tissue or adj organs |
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Pancreas T Staging
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T1: Ltd to pancreas ≤ 2 cm
T2: Ltd to pancreas > 2 cm T3: Beyond pancreas but no celiac or SMA involvement T4: Celiac or SMA involvement |
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Pancreas Stage Grouping
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IA: T1N0M0
IB: T2N0M0 IIA: T3N0M0 IIB: T1-3N1M0 III: T4NxM0 IV: TxNXM1 |
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Mesothelioma T Staging
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T1a: Ipsi parietal pleura without visceral pleura
T1b: Ipsi parietal pleura with focal visceral pleura T2: Ipsi parietal pleura and - Confluent visceral pleura +/- diaphragm +/- lung parenchyma T3: Ipsi pleural and - Endothoracic fascia +/- mediastinal fat +/- solitary chest wall ST focus +/- non-transmural pericardium T4: Ipsi pleural and - Diffuse or multifocal chest +/- wall +/- any rib or spine +/- through diaphragm +/- any med organ +/- direct extension to contra pleura +/- internal pericardium or pericardial effusion positive +/- myocardium +/- brachial plexus |
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Mesothelioma N Staging
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N1: Ipsi bronchopulm or hilar nodes
N2: Subcarinal nodes +/- ipsi IN or med nodes N3 - Contra med, IMN, hilar nodes +/- - Any supraclav or scalene nodes |
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Mesothelioma Stage Grouping
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IA: T1aN0M0
IB: T1bN0M0 II: T2N0M0 III: T1-2N1M0, T1-2N2M0, T3N0-2M0 IV: T4NxM0, TxN3M0, TxNxM1 |
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Bone T Staging
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T1: ≤ 8 cm
T2: > 8 cm T3: Discontinuous tumors |
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Bone Stage Grouping
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IA: T1N0M0G1/2
IB: T2N0M0G1/2 IIA: T1N0M0G3/4 IIB: T2N0M0G3/4 III: T3N0M0Gx IVA: TxN0M1aGx IVB: TxN1MxGx, TxNxM1bGx |
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Bone G Staging
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G1: Well diff/Low grade
G2: Mod diff/Low grade G3: Poorly diff/High grade G4: Undiff/High grade |
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Bone Histologies
1 2 3 4 5 6 7 8 |
1 Osteosarcoma
2 Chondrosarcoma 3 PNET/Ewing's sarcoma 4 Angiosarcoma 5 Fibrosarc/MFH 6 Chordoma 7 Adamantinoma 8 Other |
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Skin T Staging
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T1: ≤ 2 cm
T2: 2 < X ≤ 5 cm T3: > 5 cm T4: Deep extradermal structures - Cartilage - Skeletal muscle - Bone |
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Skin Stage Grouping
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I: T1N0M0
II: T2-3N0M0 III: T4N0M0, TxN1M0 IV: TxNxM1 |
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Melanoma T Staging
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T1a ≤ 1.0 mm without ulceration
T1b ≤ 1.0 mm, level II or III, no ulceration T2a 1.01-2 mm, no ulceration T2b 1.01-2 mm with ulceration T3a 2.01-4 mm no ulceration T3b 2.01-4 mm with ulceration T4a > 4.0 mm no ulceration T4b > 4.0 mm with ulceration |
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Melanoma N Staging
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N1a: Microscopic mets in one node
N1b: Macroscopic mets in one node N2a: Micro mets in 2-3 nodes N2b: Macroscopic miets in 2-3 nodes N2c: Satellite or in-transit mets without nodal mets N3 - Mets in > 3 nodes - Matted nodes - Intransit mets or satellites in regional nodes |
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Melanoma M Staging
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M1a: Skin, subcu tissues, distant nodes
M1b: Lung M1c - `All other sites - Distant mets with elevated LDH |
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Melanoma Stage Grouping
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IA: T1aN0M0
IB: T1b/T2aN0M0 IIA: T2b/T3aN0M0 IIB: T3b/T4aN0M0 IIC: T4bN0M0 III: TxN1-3M0 IV: TxNxM1 |
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Kidney T Staging
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T1a ≤ 4 cm, ltd to kidney
T1b 4 < X ≤ 7 cm, ltd to kidney T2 > 7 cm, ltd to kidney T3a - Major veins - Adrenal or perinephric tissues - Not beyond Gerota's fascia T3b - Renal vein or segmental branches - Vena cava grossly below diaphragm T3c - Vena cava grossly above diaphgram - Wall of vena cava T4 Beyond Gerota's fascia |
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Kidney N Staging
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N1: Single regional node
N2: > 1 regional node |
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Kidney Stage Grouping
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I: T1N0M0
II: T2N0M0 III: T3N0M0, T1-3N1M0 IV: T4N0-1M0, TxN2M0, TxNxM1 |
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Renal Pelvis/Ureter T Staging
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T1: Subepithelial connective tissue
T2: Muscularis T3 - Peripelvic fat (both) - Renal parenchyma (renal pelvis only) T4 - Adj organs - Through kidney into perinephric fat |
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Renal Pelvis/Ureter N Staging
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N1: Single node ≤ 2 cm
N2 - Single node 2 < X ≤ 5 cm - Multiple nodes ≤ 5 cm N3: > 5 cm |
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Renal Pelvis/Ureter Stage Grouping
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I: T1N0M0
II: T2N0M0 III: T3N0M0 IV: T4N0M0, TxN1-3M0, TxNxM1 |
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Eyelid T Staging
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T1
- Any size without tarsal plate - ≤ 5 mm at margin T2 - Invades tarsal plate - 5 < X ≤ 10 mm at margin T3 - Full eyelid thickness - > 10 mm at margin T4 Adj structures |
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Eyelid Stage Grouping
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None
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Conjunctiva T Staging
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T1: ≤ 5 mm
T2: > 5 mm without adj structures T3: Adj structures except orbit T4a: Orbital soft tissue without bone T4b: Bone T4c: Adj paranasal sinuses T4d: Brain |
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Conjunctiva Stage Grouping
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None
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Lymphoid Staging
1 Site 2 Laterality 3 histopathologic type 4 Ann Arbor stage |
1 Site: Nodal or extranodal
2 Laterality: Right, Left, Bilateral 3 Histo type: Working Formulation, REAL Classification, T-Cell/NK Neoplasms 4 Ann Arbor stage |
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Lymphoid Staging: Ann Arbor
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I: Single nodal region
IE: Localized single extralymphatic organ without lymph node involvement II: ≥ 2 lymph node regions on same side of diaphragm IIE: Single exralymphatic organ with regional node involvement +/- other nodes on same side of diaphragm III: Nodes on both sides of diaphragm IIIE: Nodes on both sides +/- extralymphatic extension with adj nodes IIIS: With spleen IIIE,S: With extranodal and spleen IV: Diffuse involvement with liver, bone marrow, or nodular lung |
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Lymphoid Prognostic Factors
IPI Score |
Ann Arbor Stage III or IV = 1
LDH > max normal = 1 Age ≥ 60 = 1 Extranodal disease > 1 site = 1 PFS ECOG ≥ 2 = 1 0-1 point: Low 2 points: Low intermediate 3 points: High intermediate 4-5 points: High |
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Malignant Melanoma of Uvea:
Choroid and Ciliary Body T Staging |
T1a ≤ 10 mm d and ≤ 2.5 mm ht without micro extraoc ext
T1b ≤ 10 mm d and ≤ 2.5 mm ht with micro extraoc ext T1c ≤ 10 mm d and ≤ 2.5 mm ht with macro extraoc ext T2a 10-16 mm d, ht 2.5-10 mm without micro extraoc ext T2b 10-16 mm d, ht 2.5-10 mm with micro extraoc ext T2c 10-16 mm d, ht 2.5-10 mm with macro extraoc ext T3 > 16 mm d or > 10 mm ht wihtout extraoc ext T4 > 16 mm d or > 10 mm ht with extraoc ext |
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Malignant Melanoma of Uvea:
Choroid and Ciliary Body Stage Grouping |
I: T1N0M0
II: T2N00 III: T3N0M0, T4N0M0 IV: TxN1M0, TxNxM1 |
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Lymphoid Staging
1 Site 2 Laterality 3 histopathologic type 4 Ann Arbor stage |
1 Site: Nodal or extranodal
2 Laterality: Right, Left, Bilateral 3 Histo type: Working Formulation, REAL Classification, T-Cell/NK Neoplasms 4 Ann Arbor stage |
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Lymphoid Staging: Ann Arbor
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I: Single nodal region
IE: Localized single extralymphatic organ without lymph node involvement II: ≥ 2 lymph node regions on same side of diaphragm IIE: Single exralymphatic organ with regional node involvement +/- other nodes on same side of diaphragm III: Nodes on both sides of diaphragm IIIE: Nodes on both sides +/- extralymphatic extension with adj nodes IIIS: With spleen IIIE,S: With extranodal and spleen IV: Diffuse involvement with liver, bone marrow, or nodular lung |
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Lymphoid Prognostic Factors
IPI Score |
Ann Arbor Stage III or IV = 1
LDH > max normal = 1 Age ≥ 60 = 1 Extranodal disease > 1 site = 1 PFS ECOG ≥ 2 = 1 0-1 point: Low 2 points: Low intermediate 3 points: High intermediate 4-5 points: High |
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Malignant Melanoma of Uvea:
Choroid and Ciliary Body T Staging |
T1a ≤ 10 mm d and ≤ 2.5 mm ht without micro extraoc ext
T1b ≤ 10 mm d and ≤ 2.5 mm ht with micro extraoc ext T1c ≤ 10 mm d and ≤ 2.5 mm ht with macro extraoc ext T2a 10-16 mm d, ht 2.5-10 mm without micro extraoc ext T2b 10-16 mm d, ht 2.5-10 mm with micro extraoc ext T2c 10-16 mm d, ht 2.5-10 mm with macro extraoc ext T3 > 16 mm d or > 10 mm ht wihtout extraoc ext T4 > 16 mm d or > 10 mm ht with extraoc ext |
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Malignant Melanoma of Uvea:
Choroid and Ciliary Body Stage Grouping |
I: T1N0M0
II: T2N00 III: T3N0M0, T4N0M0 IV: TxN1M0, TxNxM1 |
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Define vulvar N3/FIGO IVA
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Fixed or ulcerated regional LN mets
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Define vulvar FIGO stage IIIB
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T1-2 N2a-N2b M0
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Define vulvar FIGO stage IIIC
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T1-2 N2c M0
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Define vulvar FIGO stage IVA
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T1-2 N3 M0
T3 Any N M0 |
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Define vulvar FIGO stage IVB
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Any T Any N M1
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