15 Questions
What is the primary characteristic used to classify a primary tumor as T1 to T4?
The increasing size of the primary lesion
What does the NX notation indicate in the TNM staging system?
Regional lymph nodes cannot be assessed
What is the primary purpose of the TNM staging system?
To predict tumor behavior and prognosis
What does the M1 notation indicate in the TNM staging system?
The presence of distant metastases
Which of the following is NOT a component of the TNM staging system?
Type of cancer cells present
What is the classification of a primary tumor that invades the muscularis propria in rectal cancer?
T2
A patient with breast cancer has metastases in 4-9 axillary nodes. What is the correct N classification?
N2
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%
What is the characteristic of Grade I tumors in terms of differentiation?
They are well-differentiated and closely resemble the normal parent cells.
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
Which of the following lymph node involvement is associated with Stage III?
Nodes involved on both sides of the diaphragm, plus the spleen.
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
What is the primary factor in determining the aggressiveness of a tumor based on the grading system?
The cytological differentiation of tumor cells.
What is the characteristic of a tumor with distant metastasis in the bone marrow?
It is classified as Stage IV.
What is the designation of a poorly differentiated tumor in the grading system?
G3.
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
- Breast ductal carcinoma:
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
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.
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