Wednesday, December 24, 2014

Gynecological Tumours

Cervix uteri and corpus uteri were among the first sites to be classified by the TNM system. The "League of Nations" stages for carcinoma of the cervix have been used with minor modifications for over 50 years, and, because these are accepted by the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO), the TNM categories have been defined to correspond to the FIGO stages. Some amendments have been made in collaboration with FIGO, and the classifications now published have the approval of the FIGO, UICC, and the national TNM committees including the AJCC.
Each site is described under the following headings:
  • Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment
  • Anatomical subsites where appropriate
  • Definition of the regional lymph nodes
  • TNM Clinical classification
  • pTNM Pathological classification
  • Stage grouping
  • Summary

2. Distant Metastasis

The categories M1 and pM1 may be further specified according to the following notation:

Pulmonary PUL Bone marrow MAR
Osseous OSS Pleura PLE
Hepatic HEP Peritoneum PER
Brain BRA Adrenals ADR
Lymph nodes LYM Skin SKI
Others OTH

3. Histopathological Grading

The definitions of the G categories apply to all classified tumours except gestational trophoblastic tumours. These are:

GX. Grade of differentiation cannot be assessed
G1. Well differentiated
G2. Moderately differentiated
G3. Poorly differentiated or undifferentiated

4. R Classification

The absence or presence of residual tumour after treatment is described by the symbol R. The definitions of the R classification are:
RX. Presence of residual tumour cannot be assessed
R0. No residual tumour
R1. Microscopic residual tumour
R2. Macroscopic residual tumour