Small Intestine Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]-Stage Information for Small Intestine Cancer The treatment sections of this summary are organized according to histopathologic type rather than stage.

Definitions of TNM

The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define small intestine cancer.[1]

Table 1. Primary Tumor (T)a

a Reprinted with permission from AJCC: Small intestine. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 127-32.
b The nonperitonealized perimuscular tissue is, for jejunum and ileum, part of the mesentery and, for duodenum in areas where serosa is lacking, part of the interface with the pancreas.
TX	Primary tumor cannot be assessed.
T0	No evidence of primary tumor.
Tis	Carcinomain situ.
T1a	Tumor invades lamina propria.
T1b	Tumor invades submucosa.b
T2	Tumor invades muscularis propria.
T3	Tumor invades through the muscularis propria into the subserosa or into the nonperitonealized perimuscular tissue (mesentery or retroperitoneum) with extension ≤2 cm.b
T4	Tumor perforates the visceral peritoneum or directly invades other organs or structures (includes other loops of small intestine, mesentery, or retroperitoneum >2 cm, and abdominal wall by way of serosa; for duodenum only, invasion of pancreas or bile duct).

Table 2. Regional Lymph Nodes (N)a

a Reprinted with permission from AJCC: Small intestine. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 127-32.
NX	Regional lymph nodes cannot be assessed.
N0	No regional lymph node metastasis.
N1	Metastasis in 1-3 regional lymph nodes.
N2	Metastases in ≥4 regional lymph nodes.

Table 3. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Small intestine. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 127-32.
M0	No distant metastasis.
M1	Distant metastasis.

Table 4. Anatomic Stage/Prognostic Groupsa

Stage	T	N	M
a Reprinted with permission from AJCC: Small intestine. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 127-32.
0	Tis	N0	M0
I	T1	N0	M0
	T2	N0	M0
IIA	T3	N0	M0
IIB	T4	N0	M0
IIIA	Any T	N1	M0
IIIB	Any T	N2	M0
IV	Any T	Any N	M1

References:

1. Small intestine. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 127-32.

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