Gra a Ding Staging

7/26/2019 Gra a Ding Staging

1/15

GRADING AND STAGING OFTUMORS

Dr. Indri Windarti, Sp.PA


2/15

GRADING

Degree of maturity or differentiationunder te mi!ro"!ope

#. $i"to%ogi! grade & re"em'%an!e 'et(een

tumor and norma% !e%%"). Nu!%ear grade & "i*e and "ape of

nu!%eu", di+iding !e%%"

.

Deraat maturita"dan diferen"ia"i "e%

#.$i"to%ogi! grade &'d"- -emiripan "e%tumor dgn "e%norma%

).Nu!%ear grade &u-uran dan 'entu-

inti, mito"i"


3/15

TUMORGRADES

Mi!ro"!opi! apperan!e of !an!er !e%%" degree" of "e+erity

Grade/

G0 Grade !annot 'e a""e""ed 1Undeterminedgrade2

G# We%%3differentiated 14o( grade2

G) Moderate%y differentiated 1Intermediate

grade2G5 Poor%y differentiated 1$ig grade2

G Undifferentiated 1$ig grade2


4/15

GRADINGSYSTEMS

Different for different type" of!an!er"

G%ea"on & pro"tate !an!er6%"ton36%%i" & 'rea"t !an!erFurman & -idney !an!er

G%ea"on"y"tem

Furman "y"tem


5/15

GRADING TREATMENT

For treatment and progno"i"

4o(er grade

'etter progno"i" 1out!ome of diea"e2$iger grade (or"e progno"i"

Important in treatment of prim. 'rain tumor"1a"tro!ytoma"2,%ympoma", 'rea"t !an!er,

pro"tate


6/15

STAGING

Per%ua"an tumor primer danpenye'arannya -e 'agian tu'u

7egunaan/

3 meren!ana-an pengo'atan

3 e"tima"i progno"i"


7/15

Staging klinis

Ti" i" an e"timate of o( mu! !an!ertere i" 'a"ed on te py"i!a% e8am,imaging te"t" 183ray", 9T "!an", et!.2, andtumor 'iop"ie".

For "ome !an!er", te re"u%t" of oter te"t","u! a" '%ood te"t", are a%"o u"ed in "taging.

Te !%ini!a% "tage i" a -ey part of de!idingte 'e"t treatment to u"e.

It:" a%"o te 'a"e%ine u"ed for !ompari"on(en %oo-ing at te !an!er:" re"pon"e to

treatment.


8/15Staging patologis

Pato%ogi!a% "taging 1a%"o !a%%ed "urgi!a% "taging2re%ie" on (at i" %earned a'out te !an!er during

"urgery.Often ti" i" "urgery to remo+e te !an!er and

near'y %ymp node", 'ut "ometime" "urgery may'e done to u"t %oo- at o( mu! !an!er i" in te'ody and ta-e out ti""ue "amp%e".

In "ome !a"e", te pato%ogi! "tage may 'edifferent from te !%ini!a% "tage 1for in"tan!e, if te"urgery "o(" te !an!er a" "pread more tan it(a" tougt to a+e "pread 'efore "urgery2.

Te pato%ogi!a% "tage gi+e" te ea%t !are teammore pre!i"e information tat !an 'e u"ed topredi!t treatment re"pon"e and out!ome"1progno"i"2.


9/15

STAGING SYSTEMS

No uni;ue "taging "y"tem

Common elements / 3 4o!ation of te primary tumor

3 Tumor "i*e and num'er of tumor"

3 4ymp node in+o%+ement 1"pread of!an!er into %ymp node"2

3 Pre"en!e or a'"en!e of meta"ta"i"


10/15

TNM - sstem

Mo"t !ommon 1a!!epted 'y UI99, A


11/15

Primary Tumor (T)

TX Primary tumor cannot be evaluated

T0 No evidence of primary tumor

Tis Carcinoma in situ (has not spread) T1, T, T!, T" #i$e and%or e&tent of the primary tumor

Regional Lymph Nodes (N)

NX 'eional lymph nodes cannot be evaluated

N0 No reional lymph node involvement

N1, N, N! nvolvement of reional lymph nodes (number

and%or e&tent of spread)

Distant Metastasis (M)

*X +istant metastasis cannot be evaluated

*0 No distant metastasis*1 +istant metastasis (cancer has spread to distant parts

of the body)staging


12/15

6a! !an!er type a" it" o(n +er"ion of ti"!%a""ifi!ation "y"tem, "o %etter" and num'er"

don:t a%(ay" mean te "ame ting for e+ery-ind of !an!er.

For e8amp%e, in "ome type" of !an!er T# mean"te tumor i" "ma%%er tan a !entimeter, 'ut in

anoter type a T# may 'e up to ) !entimeter".In "ti%% anoter !an!er type, T may te%% o( far

te !an!er a" in+aded into te %ayer" of ti""ue.


13/15

OT$ER C%ASSI&ICATION

nn rbour lymphomas

+u-e.s classificationcolon cancer

/reslo scale and Clar-.s levelmelanoma


14/15

Py"i!a% e8am"

e8amination, %oo-ing,

%i"tening

Imaging "tudie" 03ray,

US, 9T, MRI, P6T4a'oratory te"t" '%ood,

urine, AST>A4T, tumor

mar-er" 19A#?3?,9A#?3

@.2Pato%ogy report"

'iop"y, !yto%ogy

Surgi!a% report"


15/15

'"estions(

Documents

Gra a Ding Staging