Radiation Oncology/Carcinoid/GI Carcinoid

Gastrointestinal Carcinoid Tumors See also: Carcinoid of the appendix Staging Was added as a separate classification starting with the 7th edition of the AJCC Staging Manual. Carcinoids were not previously classified by the AJCC. This staging is applicable to carcinoids of the stomach, colon, rectum, and ampulla of vater. There is a separate staging system for carcinomas arising within the appendix and for neuroendocrine tumors of the pancreas. AJCC 7th Edition (2009) Primary Tumor Duodenum, Ampulla, Jejunum, or Ileum T1 - small intestinal tumors: invades lamina propria or submucosa and 1 cm or less; ampullary tumors: 1 cm or less T2 - small intestinal tumors: invades muscularis propria or size > 1 cm; ampullary tumors: tumor > 1 cm T3 - jejunum/ileum: invades through muscularis propria into subserosal tissue without penetration of overlying serosa; ampullary or duodenum: invades pancreas or retroperitoneum; or into non-peritonealized tissues T4 - invades visceral peritoneum (serosa) or other organs Colon or Rectum T1 - invades lamina propria or submucosa and 2 cm or less T1a - <1 cm T1b - 1-2 cm T2 - invades muscularis propria, or size > 2 cm T3 - invades through muscularis propria into subserosal tissue; or into non-peritonealized pericolic or perirectal tissues T4 - invades peritoneum or other organs Regional Lymph Nodes N0 - none N1 - yes Distant Metastasis M0 - none M1 - yes Stage Grouping I - T1 N0 IIA - T2 N0 IIB - T3 N0 IIIA - T4 N0 IIIB - N1 IV - M1