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Question

Gentleman of 56 years underwent laparoscopic left hemicolectomy for diagnosed left colonic carcinoma. Histopathology revealed the tumour to be invading submucosa and muscularis propria. Among the 16 regional lymph nodes harvested, 2 were positive for malignant deposits.
His staging as per AJCC will be:

The correct answer is
T2, N1, M0

Colorectal Cancer Staging: AJCC Criteria

The American Joint Committee on Cancer (AJCC) staging system uses the TNM classification to describe the extent of cancer. We need to determine the T, N, and M components based on the provided histopathology report.

Determining the T (Tumor) Stage

The report states the tumor is invading the submucosa and muscularis propria.

  • T1 stage indicates tumor invasion limited to the submucosa.
  • T2 stage indicates tumor invasion into the muscularis propria.

Since the tumor invades the muscularis propria, the T stage is T2.

Determining the N (Node) Stage

The report mentions that out of 16 harvested regional lymph nodes, 2 were positive for malignant deposits.

  • N0 means no regional lymph node metastasis.
  • N1 means metastasis in 1 to 3 regional lymph nodes.
  • N2 means metastasis in 4 or more regional lymph nodes.

With 2 positive lymph nodes, the N stage is N1.

Determining the M (Metastasis) Stage

The question does not provide any information regarding distant metastasis. By convention in staging, if distant metastasis is not mentioned or detected, it is assumed to be absent.

Therefore, the M stage is M0.

Final AJCC Staging

Combining the T, N, and M stages, the patient's AJCC staging is T2, N1, M0.

This corresponds to Option B.

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