NCCN Guidelines for Patients® | Colon Cancer - page 24

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NCCN Guidelines for Patients™: Colon Cancer
Version 1.2012
Part 3: Tests of colon cancer
The 5 stages of colon cancer
TNM scores are used to assign the cancer a
stage. Each stage is represented by Roman
numerals ranging from 0 to IV. Stages II
through IV have substages marked with letters.
The stages identify tumor types that have a
similar prognosis and thus are treated in a
similar way. Table 1 lists the staging groups
by TNM scores. Also, two other definitions of
staging are included but these definitions are
not used often.
Your two sets of TNM scores will be used to
assign a cancer stage twice. The first set of
scores is used for clinical staging. The clinical
stage is used for making an initial treatment
plan. However, the clinical stage may be wrong
about how far the cancer has spread. The
second set of scores is used for pathologic
staging. Most of the time, the pathologic stage
is the most important stage. This is because
your lymph nodes can only be completely
examined under a microscope. In general,
earlier stages of colon cancer have a better
prognosis.
*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.
Used with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original
source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer
Science+Business Media, LLC,
Anatomic stage/prognostic groups
Group T
N
M Dukes* MAC*
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
B
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
Table 1. Staging of colon cancer
1...,14,15,16,17,18,19,20,21,22,23 25,26,27,28,29,30,31,32,33,34,...84
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