Radiation Oncology/Carcinoid/GI Carcinoid

Gastrointestinal Carcinoid Tumors

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