Richtlijn Galweg- en Galblaascarcinoom Versie - Oncoline
Richtlijn Galweg- en Galblaascarcinoom Versie - Oncoline
Richtlijn Galweg- en Galblaascarcinoom Versie - Oncoline
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H 11 TNM Classificatie <strong>en</strong> Classificatie van Bismuth<br />
11.1. TNM Classificatie<br />
In 2009 versche<strong>en</strong> de zev<strong>en</strong>de editie van de TNM Classification of Malignant Tumours.<br />
<strong>Galblaascarcinoom</strong><br />
Gallbladder (ICD-O C23)<br />
Rules for Classification<br />
The classification applies to carcinomas of gallbladder and cystic dust. There should be<br />
histological confirmation of the disease.<br />
The following are the procedures for assessing T, N, and M categories:<br />
T categories Physical examination, imaging, and/or surgical exploration<br />
N categories Physical examination, imaging, and/or surgical exploration<br />
M categories Physical examination, imaging, and/or surgical exploration<br />
Regional Lymph Nodes<br />
Regional lymph nodes are the hepatic hilus nodes (including nodes along the common bile<br />
duct, common hepatic artery, portal vein, and cystic duct).<br />
Coeliac, periduod<strong>en</strong>al, peripancreatic, and superior mes<strong>en</strong>teric artery node involvem<strong>en</strong>t is<br />
considered distant metastasis (M1).<br />
T - Primary Tumour (zie figuur hoofdstuk chirurgische behandeling galblaascarcinoom)<br />
TX Primary tumour cannot be assessed<br />
T0 No evid<strong>en</strong>ce of primary tumour<br />
Tis Carcinoma in situ<br />
T1 Tumour invades lamina propria or muscular layer<br />
T1a Tumour invades lamina propria<br />
T1b Tumour invades muscular layer<br />
T2 Tumour invades perimuscular connective tissue; no ext<strong>en</strong>sion beyond serosa or into<br />
liver<br />
T3 Tumour perforates the serosa (visceral peritoneum) and/or directly invades the liver<br />
and/or one other adjac<strong>en</strong>t organ or structure, such as stomach, duod<strong>en</strong>um, colon,<br />
pancreas, om<strong>en</strong>tum, extrahepatic bile ducts<br />
T4 Tumour invades main portal vein or hepatic artery or invades two or more extrahepatic<br />
organs or structures<br />
N - Regional Lymph Nodes<br />
NX Regional lymph nodes cannot be assessed<br />
N0 No regional lymph node metastasis<br />
N1 Regional lymph node metastasis (including nodes along the cystic duct, common bile<br />
duct, common hepatic artery, and portal vein)<br />
M - Distant Metastasis<br />
M0 No distant metastasis<br />
M1 Distant metastasis<br />
Concept <strong>Richtlijn</strong> galweg- <strong>en</strong> galblaascarcinoom vs accoord werkgroep Pagina 47 van 75<br />
11 juli 2012
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