TNM 7 Classification





TNM 6 Classification



Introduction


The following classification for carcinoma of the fallopian tube
is based on that of FIGO adopted in 1992. The definitions of the
T, N, and M categories correspond to the FIGO stages. Both systems
are included for comparison.

1. Rules for Classification


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


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



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

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

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



The FIGO stages are based on surgical staging. (TNM stages are based on clinical
and/or pathological staging.)

2. Regional Lymph Nodes


The regional lymph nodes are the hypogastric (obturator), common
iliac, external iliac, lateral sacral, para-aortic, and inguinal
nodes.

3. TNM Clinical Classification


3.1. T - Primary Tumour































































































TNM Categories
 FIGO Stages
TX
Primary tumour cannot be assessed
T0
No evidence of primary tumour
Tis
 0
 Carcinoma in situ (preinvasive carcinoma)
T1
 I
 Tumour confined to fallopian tube(s)
T1a
 IA
 Tumour limited to one tube, without penetrating the serosal surface
T1b
 IB
 Tumour limited to both tubes, without penetrating the serosal surface
T1c
 IC
 Tumour limited to one or both tube(s) with extension onto or through the tubal serosa, or with malignant cells in ascites or peritoneal washings
T2
 II
 Tumour involves one or both fallopian tube(s) with pelvic extension
T2a
 IIA
 Extension and/or metastasis to uterus and/or ovaries
T2b
 IIB
 Extension to other pelvic structures
T2c
 IIC
 Pelvic extension (2a or 2b) with malignant cells in ascites or peritoneal washings
T3 and/or N1
 III
 Tumour involves one or both fallopian tube(s) with peritoneal implants outside the pelvis and/or positive regional lymph nodes
T3a
 IIIA
 Microscopic peritoneal metastasis outside the pelvis
T3b
 IIIB
 Macroscopic peritoneal metastasis outside the pelvis 2 cm or less in greatest dimension
T3c and/or N1
 IIIC
 Peritoneal metastasis more than 2 cm in greatest dimension and/or positive regional lymph nodes
M1
 IV
 Distant metastasis (excludes peritoneal metastasis)




Note: Liver capsule metastasis is T3/stage III, liver parenchymal metastasis, M1/ stage IV. Pleural effusion must have positive cytology for M1/stage IV.



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

5. G Histopathological Grading


GX. Grade of differentiation cannot be assessed

G1. Well differentiated

G2. Moderately differentiated

G3. Poorly differentiated

G4. Undifferentiated


6. Stage Grouping

















































































Stage 0
 Tis
 N0
 M0
Stage IA
 T1a
 N0
 M0
Stage IB
 T1b
 N0
 M0
Stage IC
 T1c
 N0
 M0
Stage IIA
 T2a
 N0
 M0
Stage IIB
 T2b
 N0
 M0
Stage IIC
 T2c
 N0
 M0
Stage IIIA
 T3a
 N0
 M0
Stage IIIB
 T3b
 N0
 M0
Stage IIIC
 T3c
 N0
 M0
Any T
 N1
 M0
Stage IV
 Any T
 Any N
 M1







7. Summary















































































TNM
 Fallopian Tube
 FIGO
T1
 Limited to tube(s)
 I
T1a
 One tube; serosa intact
 IA
T1b
 Both tubes; serosa intact
 IB
T1c
 Serosa involved; malignant cells in ascites or peritoneal washings
 IC
T2
 Pelvic extension
 II
T2a
 Uterus and/or ovaries
 IIA
T2b
 Other pelvic structures
 IIB
T2c
 Malignant cells in ascites or peritoneal washings
 IIC
T3 and/or N1
 Peritoneal metastasis outside the pelvis and/or regional lymph node metastasis
 III
T3a
 Microscopic peritoneal metastasis
 IIIA
T3b
 Macroscopic peritoneal metastasis ≤2 cm
 IIIB
T3c and/or N1
 Peritoneal metastasis >2 cm and/or regional lymph node metastasis
 IIIC
M1
 Distant metastasis (excludes peritoneal metastasis)
 IV