Rectal Cancer - Staging

2009 AJCC 7th Edition

T1 - Submucosal invasion

T2 -Suscularis propria

T3 - Serosal invasion, invades peri-rectal fat

T4a - Invades peritoneal viscera

T4b - Invades local structures

N1 - 1-3 lymph nodes

N2a - 4 - 7 lymph nodes

N2b - > 7 LNs

M1a - Metastasis to one site

M1b - Metastasis to more than one site or peritoneum

Stage I - T1-2N0

Stage IIa - T3N0

Stage IIb - T4aN0

Stage IIIa - T1-2N1, T1N2a

Stage IIIb - T3-4aN1, T2-3N2a, T1-2N2b

Stage IIIc - T4aN2a, T3-4aN2b, T4bN1-2

Stage IVa - TxNxM1a

Stage IVb - TxNxM1b

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Investigations:

CT abdo/pelvis

EUS or MRI pelvis

CXR

CBC, LFTs, SMA7, RFTs, CEA

Colonoscopy