Gastrointestinal stromal tumor staging
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Diagnosis |
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Case Studies |
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Gastrointestinal stromal tumor staging On the Web |
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American Roentgen Ray Society Images of Gastrointestinal stromal tumor staging |
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Directions to Hospitals Treating Gastrointestinal stromal tumor |
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Risk calculators and risk factors for Gastrointestinal stromal tumor staging |
Stage Information for GIST
Definitions of TNM (for GIST at All Sites)
A formal staging system for gastrointestinal stromal tumors (GIST) appeared for the first time in the 7th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual.[1] Because of the limited availability of mutation testing, mutation status is not included in the AJCC system. In addition, since nodal involvement is so rare, and nodal dissection is not indicated, the designation N0/pN0 should be used in the absence of information about the regional nodes. Note that treatment decisions may not be based strictly on the stage of disease.[2-4]
Definitions of TNM (for GIST at All Sites)
This staging system for GIST is new for the 7th edition of the AJCC Cancer Staging Manual.[1]
Table 2. Primary Tumor (T)a
aReprinted with permission from AJCC: Gastrointestinal stromal tumor. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9.
TX Primary tumor cannot be assessed.
T0 No evidence for primary tumor.
T1 Tumor ≤2 cm.
T2 Tumor >2 cm but not >5 cm.
T3 Tumor >5 cm but not >10 cm.
T4 Tumor >10 cm in greatest dimension.
Table 3. Regional Lymph Nodes (N)a
aReprinted with permission from AJCC: Gastrointestinal stromal tumor. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9.
NX Regional lymph nodes cannot be assessed.
N0 No regional lymph node metastasis.
N1 Regional lymph node metastasis.
Table 4. Distant Metastasis (M)a
aReprinted with permission from AJCC: Gastrointestinal stromal tumor. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9.
M0 No distant metastasis.
M1 Distant metastasis.
Table 5. Anatomic Stage/Prognostic Groupsa
gist = gastrointestinal stromal tumors.
aReprinted with permission from AJCC: Gastrointestinal stromal tumor. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9.
bAlso to be used for omentum.
cAlso to be used for esophagus, colorectal, mesentery, and peritoneum.
Gastric GIST b
Group T N M Mitotic Rate
Stage IA T1 or T2 N0 M0 Low
Stage IB T3 N0 M0 Low
Stage II T1 N0 M0 High
T2 N0 M0 High
T4 N0 M0 Low
Stage IIIA T3 N0 M0 High
Stage IIIB T4 N0 M0 High
Stage IV Any T N1 M0 Any rate
Any T Any N M1 Any rate
Small Intestinal GIST c
Group T N M Mitotic rate
Stage I T1 or T2 N0 M0 Low
Stage II T3 N0 M0 Low
Stage IIIA T1 N0 M0 High
T4 N0 M0 Low
Stage IIIB T2 N0 M0 High
T3 N0 M0 High
T4 N0 M0 High
Stage IV Any T N1 M0 Any rate
Any T Any N M1 Any rate
References