Oncology: Staging and Grading of Malignant Tumors

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary characteristic used to classify a primary tumor as T1 to T4?

The presence or absence of blood-borne metastases

The increasing size of the primary lesion (correct)

The extent of lymph node involvement

The type of cancer cells present in the tumor

What does the NX notation indicate in the TNM staging system?

The primary tumor cannot be assessed

The presence of distant metastases

Regional lymph nodes cannot be assessed (correct)

No lymph node involvement

What is the primary purpose of the TNM staging system?

To predict tumor behavior and prognosis (correct)

To classify cancer based on the type of cancer cells

To monitor treatment response

To diagnose cancer

What does the M1 notation indicate in the TNM staging system?

The presence of distant metastases Signup and view all the answers

Which of the following is NOT a component of the TNM staging system?

Type of cancer cells present Signup and view all the answers

What is the classification of a primary tumor that invades the muscularis propria in rectal cancer?

T2 Signup and view all the answers

A patient with breast cancer has metastases in 4-9 axillary nodes. What is the correct N classification?

N2 Signup and view all the answers

In the Dukes staging system for rectal cancer, what is the 5-year survival rate for patients with tumors that have lymph node involvement?

30% Signup and view all the answers

What is the characteristic of Grade I tumors in terms of differentiation?

They are well-differentiated and closely resemble the normal parent cells. Signup and view all the answers

A patient with urinary bladder cancer has a tumor that invades the prostatic stroma, seminal vesicles, uterus, or vagina. What is the correct T classification?

T4a Signup and view all the answers

Which of the following lymph node involvement is associated with Stage III?

Nodes involved on both sides of the diaphragm, plus the spleen. Signup and view all the answers

In the Ann Arbor staging system for Hodgkin's Lymphoma, what is the classification for a patient with two or more groups of nodes involved on the same side of the diaphragm?

II Signup and view all the answers

What is the primary factor in determining the aggressiveness of a tumor based on the grading system?

The cytological differentiation of tumor cells. Signup and view all the answers

What is the characteristic of a tumor with distant metastasis in the bone marrow?

It is classified as Stage IV. Signup and view all the answers

What is the designation of a poorly differentiated tumor in the grading system?

G3. Signup and view all the answers

Study Notes

Staging of Malignant Tumors

Staging is based on:
- Size of the primary lesion
- Extent of spread to regional lymph nodes
- Presence or absence of blood-borne metastases
The American Joint Committee on Cancer (AJCC) staging system is commonly used, also known as the TNM system
TNM system:
- T: primary tumor (T1 to T4 based on increasing size)
- N: regional lymph node involvement (N0 to N3)
- M: metastases (M0 to M1 or M2)
Examples of staging for specific cancers:
- Breast ductal carcinoma:
  - T1: ≤ 2cm (20mm)
  - T2: 2 - 5 cm (20-50mm)
  - T3: ≥ 5cm (50mm)
  - T4: skin and/or chest wall involved
- Rectum:
  - T1: tumor invades submucosa
  - T2: tumor invades muscularis propria
  - T3: tumor invades through muscularis propria into pericolorectal tissues
  - T4: tumor invades through visceral peritoneum or directly invades other adjacent organs
- Urinary bladder:
  - pT1: invades lamina propria
  - pT2a: invades inner half of muscularis propria
  - pT2b: invades outer half of muscularis propria

Dukes Staging for Neoplasms of Rectum

A: Not extending through muscularis propria (>90% 5-year survival)
B: Extending through muscularis propria (70% 5-year survival)
C: Lymph nodes involved (30% 5-year survival)

Grading of Malignant Tumors

Grading is the differentiation of a tumor
Differentiation is how similar the tumor cells look compared to the cell type of origin
Grading estimates the aggressiveness or level of malignancy based on cytological differentiation and number of mitoses
Four grades are commonly used:
- GRADE I: well-differentiated, closely resembles normal parent cells
- GRADE II: moderately differentiated
- GRADE III: poorly differentiated
- GRADE IV: anaplastic, difficult to recognize cell of origin
Alternative grading system:
- G1: well-differentiated
- G2: moderately differentiated
- G3: poorly differentiated

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the key concepts of staging and grading of malignant tumors, including biological basis of cancer treatments, tumor markers, and screening. It's ideal for students of oncology and medical professionals.