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TNM classification for colorectal cancer

Tumor classification
Tx: Primary tumor cannot be assessed
T0: No evidence of primary tumor
Tis: Carcinoma in situ, intramucosal carcinoma (involvement of lamina propria with no extension through muscularis mucosae)
T1: Tumor invading submucosa (through muscularis mucosa but not into muscularis propria)
T2: Tumor invading muscularis propria
T3: Tumor invading through muscularis propria into pericolorectal tissues
T4a: Tumor invading through visceral peritoneum (including gross perforation of bowel through the tumor and continuous invasion of the tumor through areas of inflammation to the surface of visceral peritoneum)
T4b: Tumor directly invades or adheres to adjacent organs or structures
Lymph node classification
Nx: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1a: 1 positive regional lymph node
N1b: 2-3 positive regional lymph nodes
N1c: No positive regional lymph nodes, but tumor deposits in subserosa, mesentery, or nonperitonealized pericolic or perirectal/mesorectal tissues
N2a: 4-6 positive regional lymph nodes
N2b: ≥ 7 positive regional lymph nodes
Metastasis classification
M0: No distant metastasis
M1a: Metastasis to 1 site or organ with no peritoneal metastasis
M1b: Metastasis to ≥ 2 sites or organs with no peritoneal metastasis
M1c: Metastasis to the peritoneal surface, with or without other site or organ metastases
Stage cannot be fully assessed
Reference
Amin, M.B., Edge et al. AJCC Cancer Staging Manual. AJCC. 2017.
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