Radiation Oncology/Appendix-carcinoma

Carcinoma of the Appendix This chapter is about carcinomas only. For carcinoid tumors of the appendix, see Carcinoid of the appendix Staging Was added as a separate classification starting with the 7th edition of the AJCC Staging Manual. Previously, this was staged using the colorectal staging system. Carcinoid tumors of the appendix are staged separately. AJCC 7th Edition (2009) Tumor Tis - carcinoma in situ T1 - invasion of submucosa T2 - invasion of muscularis propria T3 - invasion through muscularis propria into subserosa or into mesoappendix T4 T4a - penetrates visceral peritoneum, including mucinous peritoneal tumor within the right lower quadrant T4b - directly invades other organs or structures (includes invasion of other segments of the colorectum by way of the serosa) Nodes N0 - no regional lymph node metastasis N1 - metastasis in 1-3 regional LN N2 - metastasis in 4 or more LN Distant Metastasis M0 - none M1 - distant metastasis M1a - intraperitoneal metastasis beyond the right lower quadrant, including pseudomyxoma peritonei M1b - nonperitoneal metastasis Stage grouping I - T1-2 N0 IIA - T3 N0 IIB - T4a N0 IIC - T4b N0 IIIA - T1-2 N1 IIIB - T3-4 N1 IIIC - N2 IVA - M1a N0 and Grade 1 IVB - M1a N0 and Grade 2-3, M1a and N+ (any Grade) IVC - M1b