TNM 7 classification





TNM 6 classification



1. Rules for Classification


The classification applies only to carcinomas. There should be histological
confirmation of the disease.



The following are the procedures for assessing T, N, and M categories.


T categories. Physical examination, imaging, and/or surgical exploration

N categories. Physical examination, imaging, and/or surgical exploration

M categories. Physical examination, imaging, and/or surgical exploration


2. Regional Lymph Nodes


The regional lymph nodes are:


Superior. Superior to head and body of pancreas

Inferior. Inferior to head and body of pancreas

Anterior. Anterior pancreaticoduodenal, pyloric, and proximal mesenteric

Posterior. Posterior pancreaticoduodenal, common bile duct, and proximal
mesenteric


Note: The splenic lymph nodes and those of the tail of the pancreas
are not regional; metastases to these lymph nodes are coded M1.


3. TNM Clinical Classification


3.1. T - Primary Tumour


TX. Primary tumour cannot be assessed

T0. No evidence of primary tumour

Tis. Carcinoma in situ

T1. Tumour limited to ampulla of Vater or sphincter of Oddi

T2. Tumour invades duodenal wall

T3. Tumour invades pancreas

T4. Tumour invades peripancreatic soft tissues, or other adjacent organs
or structures



3.2. N - Regional Lymph Nodes


NX. Regional lymph nodes cannot be assessed

N0. No regional lymph node metastasis

N1. Regional lymph node metastasis



3.3. M - Distant Metastasis


MX. Distant metastasis cannot be assessed

M0. No distant metastasis

M1. Distant metastasis



4. pTNM Pathological Classification


The pT, pN, and pM categories correspond to the T, N, and M categories.



pN0. Histological examination of a regional lymphadenectomy specimen
will ordinarily include 10 or more lymph nodes. If the lymph nodes are
negative, but the number ordinarily examined is not met, classify as pN0.


5. G Histopathological Grading


See definitions on Digestive System.


6. Stage Grouping


















































Stage 0TisN0M0
Stage IAT1N0M0
Stage IBT2N0M0
Stage IIAT3N0M0
Stage IIBT1, T2, T3N1M0
Stage IIIT4Any NM0
Stage IVAny TAny NM1



7. Summary































Ampulla of Vater
T1Ampulla or sphincter of Oddi
T2Duodenal wall
T3Pancreas
T4Beyond pancreas
N1Regional