Summary of Changes
A revised description of the anatomy of the colon and rectum better delineates the data concerning the boundaries between colon, rectum, and anal canal. Adenocarcinomas of the vermiform appendix are classified according to the TNM staging system but should be recorded separately, whereas cancers that occur in the anal canal are staged according to the classification used for the anus.
Smooth metastatic nodules in the pericolic or perirectal fat are considered lymph node metastases and will be counted in the N staging. In contrast, irregularly contoured metastatic nodules in the peritumoral fat are considered vascular invasion and will be coded as an extension of the T category as either a VI (microscopic vascular invasion) if only microscopically visible or a V2 (macroscopic vascular invasion) if grossly visible.
Stage Group II is subdivided into IIA and IIB on the basis of whether the primary tumor is T3 or T4, respectively.
Stage Group III is subdivided into IIIA (T1–2N1M0), HIB (T3–4N1M0)
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American Joint Committee on Cancer. (2002). Colon and Rectum. In: Greene, F.L., et al. AJCC Cancer Staging Manual. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3656-4_12
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