Stagingrad

Front 1

Hodgkin disease: staging

Back 1

Ann Arbor classification:

Stage I
single lymph-node region or extralymphatic site
Stage II
two or more sites on the same side of the diaphragm
Stage III
involvement on both sides of the diaphragm
Stage IV
disseminated disease of extralymphatic organs, with or without lymph-node involvement
Each stage is further classified as:

A
no symptoms
B
fever, sweats, weight loss

Front 2

avascular necrosis (AVN) staging FICAT

Back 2

Stage CT/xray bone scan
----- ------- ---------

I - cold/hot spot

II sclerotic focus with
osteopenic ring

III "crescent sign"
(subchondral lucency)

IV articular collapse
flattening of femoral head



sensitivity 86% 78%
specificity 79% 75%

Front 3

malignant melanoma: staging

Back 3

Clark staging:
level I: all tumor cells above basement membrane (in situ)
level II: tumor extends to papillary dermis
level III: tumor extends to interface between papillary and reticular dermis
level IV: tumor extends between bundles of collagen of reticular dermis
level V: tumor invasion of sucutaneous tissue (87% metastases)
Breslow staging:

thin: < 0.75 mm depth of invasion
intermediate: 0.76 - 3.99 mm depth of invasion
thick: > 4 mm depth of invasion

Front 4

renal adenocarcinoma: staging

Back 4

Typical presentation:
Hematuria . . . . . 70% Fever . . . . . . . 16%
Pain . . . . . . . . 50% Polycythemia . . . . 3%
Palpable mass . . . 20%


Anatomic staging (TNM):
T1 Small tumor, kidney not enlarged
T2 Large tumor, contained within renal capsule
T3 Extension into perinephric fat or renal vein
T4 Invasion of adjacent organs

Front 5

Wilms Tumor Staging

Back 5

Staging: NWTSG recommends surgical staging in every case.

Stage I: The tumor is limited to the kidney and is excised completely.
Stage II: The tumor extends beyond the kidney but is excised completely. Capsular penetration, renal vein involvement, and renal sinus involvement also may be found. A biopsy of the tumor is performed, and local spillage occurs.
Stage III: Residual intra-abdominal tumor (nonhematogenous) exists after the completion of surgery. Lymph node findings are positive, or peritoneal implants are found. The resected specimen has histologically positive margins, or the tumor has been spilled into the abdominal cavity.
Stage IV: Hematogenous or lymph node metastasis has occurred outside the abdomen or pelvis.
Stage V: Synchronous bilateral involvement has occurred. Each side is assigned a stage from I to III, and histology is based on biopsy findings.

Front 6

Neuroblastoma Staging

Back 6

Staging systems

Two staging systems are commonly in use today: the Evans and the International Neuroblastoma Staging System (INSS).

The Evans system consists of 5 stages:


Stage 1: Tumor is confined to the organ of origin.

Stage 2: Tumor extends beyond the organ of origin but does not cross midline. Ipsilateral regional lymph nodes may be involved.

Stage 3: Tumor extends beyond the midline.

Stage 4: Distant metastases are present.

Stage 4s: Known as stage 4s, this last form occurs in infants who have a localized tumor that does not cross midline, with metastatic disease confined to the liver, skin, and bone marrow. No evidence of cortical bone involvement is observed.
The INSS takes into account surgical resectability, radiologic findings, and lymph node and bone marrow involvement.


Stage 1: Localized tumor is confined to the organ of origin; complete resection with or without microscopic residual tumor; ipsilateral and contralateral lymph nodes are microscopically negative.

Stage 2a: This involves a localized tumor with incomplete gross resection; ipsilateral and contralateral lymph nodes are microscopically negative.

Stage 2b: This involves a unilateral tumor with incomplete or complete gross resection; ipsilateral lymph nodes are positive; contralateral lymph nodes are microscopically negative.

Stage 3: In this stage, tumor crosses the midline with or without regional lymph node involvement, unilateral tumor is associated with positive contralateral lymph nodes, or a midline tumor is found with positive bilateral lymph nodes.

Stage 4: Distant metastases are present.

Stage 4s: This occurs in infants with a localized tumor that does not cross midline, with metastatic disease confined to the liver, skin, and bone marrow (<10% tumor cells in bone marrow).

Front 7

What is the classification system for liver failure called?

Back 7

Child-Pugh