TNM Staging of Colon Cancer

The stage of tumor spread as well as the tumor grade are important in determining the prognosis for patients with cancer.

TNM	TNM
No evidence of carcinoma	T0
Carcinoma in situ (intraepithelial or invasion of lamina propria, without penetration of muscularis mucosae)	Tis
Tumor invades through the muscularis mucosae into the submucosa	T1
Tumor invades into the muscularis propria	T2
Tumor invades through the muscularis propria into the serosa, or into nonperitonealized perirectal or pericolic tissue	T3
Tumor directly invades other organs or structures and/or perforates the visceral peritoneum	T4
No regional lymph node metastasis	N0
Metastasis in 1-3 pericolic or perirectal lymph nodes	N1
Metastasis in 4 or more pericolic or perirectal lymph nodes	N2
Metastasis in any lymph node along the course of a named vascular trunk and/or metastasis to an apical node	N3
No distant metastasis	M0
Distant metastasis	M1

Comparison of the TNM and Astler-Coller modification of Dukes' stages.

Stage	TNM	Dukes' (Astler-Coller modification)
0	TisN0M0	A
I	T1N0M0 T2N0M0	B1 B1
II	T3N0M0 T4N0M0	B2 B2
III	T2N1M0 T2N2M0 T2N3M0 T3N1M0 T3N2M0 T3N3M0 T4N1M0 T4N2M0 T4N3M0	C1 C1 C1 C2 C2 C2 C2 C2 C2
IV	T2N0M1 T2N1M1 T2N2M1 T2N3M1 T3N0M1 T3N1M1 T3N2M1 T3N3M1 T4N0M1 T4N1M1 T4N2M1 T4N3M1	D

where:

• The original classification of Dukes was only for cancer of the rectum and did not include a stage for metastatic carcinoma.

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