STAGING OF ESOPHAGEAL CANCER IN HISTOPATHOLOGY EPORT.pptx

how to stage esophageal cancer

1. STAGING OF ESOPHAGEAL CANCER

2. TNM CLASSIFICATION OF MALIGNANT TUMOURS PT PRIMARY TUMOUR pTX – Primay tumour cannot be assessed. pT0 – No evidence of primary tumour . pTis - Carcinoma in situ pT1 - Tumour invade lamina propria or submucosa . pT2 - Tumour invades muscularis propria pT3 – Tumour invades adventitia pT4 – Tumour ivades adjacent structures

3. TNM CLASSIFICATION OF MALIGNANT TUMOURS( contd ) pN Regional lymph nodes pNX Regional lymph nodes cannot be assessed. pNO No regional lymph node metastasis pN1 Regional lymph node metastasis

4. TNM CLASSIFICATION OF MALIGNANT TUMOURS contd …) pM Distant metastasis pMX No distant metastasis pM1 Distant metastasis For tumour of upper thoracic oesophagus M1a Metatasis in cervial lymph nodes M1b Other distant metastasis For tumour of mid thoracic oesophagus M1a Not applicable M1b No regional lymph node or other distant metastasis.

5. TNM CLASSIFICATION OF MALIGNANT TUMOURS contd …) For tumour of lower thoracic oesophagus M1a Metastasis in coeliac lympoh nodes M1b Other distant metastasis

6. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS GROSS DESCRIPTION Maximum length of the specimen………mm Length of oesophagus ………..mm Length of stomach………mm Length of tumour ………..mm Width of tumour ………..mm Tumour edges to nearest distal margin……….mm

7. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS Tumour edges to nearest proximal margin……..mm. Type of tumour Polypoidal Other Pinned Not pinned Siewert tumour type (cardiac cancer only) Type 1 Type 2

8. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS HISTOLOGY Type of tumour Squamous Adenocarcinoma Other Differentiation by worst area Well differentiated Moderately differntiated Poorly differentiated

9. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS Depth of invasion Tis high grade dysplasia T1 Invasion of lamina propria / submucosa T2 Invasion of muscularis propria T3 Invasion beyond muscularis propria T4 Invasion of adjacent structures Serosal involvement Yes No

10. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS Proximal margin Normal Dysplasia Carcinoma Barret oesophagus Distal margin Normal Dysplasia Carcinoma

11. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS Circumferential margin involvement Yes No Not applicable (If no ;distance of carcinoma to nearest circumferential margin………mm. Vascular invasion Yes No Barret Metaplasia adjacent to tumour Yes No

12. NATIONAL DATASET FOR OESOPHAGEAL CARCINOMA HISTOPATHOLOGY REPORTS Lymph nodes Number examined ………Number positive………… Distant Metastasis Coeliac axis node positive Yes No M1a if lower thoracic carcinoma,otherwise M1b Cervical lymph