Discuss the purpose of staging Identify staging sources Review major staging systems Methods of Cancer Spread Invasion beyond adjacent tissue into other organs Lymphatic wall cancer cells travel through lymphatic vessels ID: 1040507
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2. ObjectivesDefine cancer stagingDiscuss the purpose of stagingIdentify staging sourcesReview major staging systems
3. Methods of Cancer SpreadInvasion beyond adjacent tissue into other organsLymphatic wall – cancer cells travel through lymphatic vesselsBlood-borne metastases – invasion of blood vessels
4. StagingCommon languageDeveloped by medical professionalsCommunicates cancer informationEvolved over many yearsDifferent staging systemsExtent of cancer
5. Purpose of StagingAssess extent of cancerDetermine most appropriate treatmentCure diseaseDecrease tumor burdenRelieve symptomsPrognosis of individual patientCompare local treatment results with national data
6. Staging SourcesPhysical examinationRadiology scansEndoscopic proceduresPathologic examination of tissue
7. Pathologic ExaminationNeedle biopsyFine needle aspirate (FNA)Incisional and excisional biopsyBone marrow biopsySurgical resectionPrimary site of cancerRegional lymph nodes
8. Pathology ReportPrimary siteTumor sizeHistologic typeGrade of tumorExtent of cancer within organ and beyondLymph nodes removed and positiveBiopsy or resection of distant site(s)
9. Staging SystemsSEER (Surveillance, Epidemiology and End Results) Summary StageAJCC (American Joint Committee on Cancer) Cancer Staging
10. SEER Summary StageMain CategoriesIn situLocalizedRegionalDistantBenign/BorderlineUnknown
11. In Situ Stage In situ cancer cellEpithelium of organBasement membraneParenchyma of organSource: SEER - Adapted from an illustration by Brian Shellito of Scientific American, as printed in Cancer in Michigan, The Detroit News, Nov. 1-2, 1998.
12. Localized Stage Epithelial cellsBasement membraneStroma(or parenchyma)Invasive tumor(invading the basement membrane andextending into the stroma)Source: SEER - Adapted from an illustration by Brian Shellito of Scientific American, as printed in Cancer in Michigan, The Detroit News, Nov. 1-2, 1998.
13. Regional Stage EpitheliumBasementmembraneParenchymaof organBlood orlymph vesselCapillaryInvasivetumor cellSource: SEER - Adapted from an illustration by Brian Shellito of Scientific American, as printed in Cancer in Michigan, The Detroit News, Nov. 1-2, 1998.
14. Distant Stage Development of MetastasisEpitheliumBasementmembraneBlood orlymph vesselSource: SEER Adapted from an illustration by Brian Shellito of Scientific American, as printed in Cancer in Michigan, The Detroit News, Nov. 1-2, 1998.Metastatic cellin circulationEpithelial liningof vesselTumor celladhering tocapillaryTumor cellpenetratescapillary wallSecondarytumor site
15. AJCC Cancer StagingClassification ComponentsT = Primary TumorSize and invasionN = Regional Lymph NodesPresence or absence of tumor in lymph nodesM = Distant MetastasisPresence or absence of distant metastasesStage Group – assigned using table
16. Staging SummarySources are available to stage cancerTreatment is based on extent of cancerSeveral major staging systems usedPrognosis of cancer can be establishedEnd result analysis of cancers
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