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 the cystic duct node and the pericholedochal,
hilar, peripancreatic (head only), periduodenal, periportal, coeliac, and superior
mesenteric nodes.
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 invades lamina propria or muscle layer
T1a. Tumour invades lamina propria
T1b. Tumour invades muscle layer
T2. Tumour invades perimuscular connective tissue, no extension beyond serosa
or into liver
T3. Tumour perforates serosa (visceral peritoneum) and/or directly invades the
liver and/or one other adjacent organ or structure, e.g., stomach, duodenum,
colon, pancreas, omentum, extrahepatic bile ducts
T4. Tumour invades main portal vein or hepatic artery, or invades two or more
extrahepatic 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 3 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
GX. Grade of differentiation cannot be assessed
G1. Well differentiated
G2. Moderately differentiated
G3. Poorly differentiated
G4. Undifferentiated
6. Stage Grouping
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7. Summary
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