Executive Summary
The stages of adrenal gland tumor explain the tumor’s location in the adrenal gland, its metastasis and how it has affected the other body parts. The stages of adrenal gland tumors are described as the TNM system. The standard adrenal cancer staging system involves stages I to IV (1 to 4). These different stages provide a general way to describe cancer so that doctors can work together to plan the best treatment. Recurrence is another stage of adrenal gland tumor that has the chance of recurrence of cancer even after the treatment. In fact, several tests and scans are often similar to those done at the initial diagnosis.
Staging system of Adrenal Gland Tumor
Under the stages of Adrenal Gland Tumor, staging is a way to explain where the tumor is, whether it is cancerous, whether cancer has spread, where it has spread, and whether it affects other parts of the body. Hence, doctors use many diagnostic tests to find the stage of a tumor. Staging may not be complete until all examinations or surgical resections of the tumor or adrenal glands have been completed 1. Undeniably, knowing the cancer stage helps doctors recommend the best treatment and predict the patient’s prognosis or chance of recovery. There is a different stage description for each type of tumor.
TNM staging system
One of the tools doctors use to explain the stages of Adrenal Gland Tumor is the TNM system. Doctors utilize the results of diagnostic tests and scans to answer the following questions:
Tumor (T): What is the size of the primary tumor? Where is it?
Node (N): Has the tumor spread to the lymph nodes? If so, where and how much?
Metastasis (M): Has cancer spread to other body parts? If so, where and how much?
Combine the results to determine the stage of each person’s cancer. This section describes a standard adrenal cancer staging system. The system has four stages, stages I to IV (1 to 4). The stage provides a general way to describe cancer so that doctors can work together to plan the best treatment. Details of each part of the adrenal cancer TNM system are as follows:
Also Read: Screening of Adrenal Cancer
The Tumor (T)
The TNM system uses the letter “T” and letters or numbers (0-4) to describe the size and location of the tumor. Tumor size is measured in centimeters (cm). Some stages are also classified as smaller groups that help explain the tumor in more detail. Below you will find specific information about the stage of cancer.
TX: Primary tumor cannot be evaluated.
T0: No primary tumour.
T1: Tumor is less than 5 cm and has not grown outside the adrenal glands.
T2: Tumor is more significant than 5 cm and does not grow outside the adrenal glands.
T3: Tumor can be of any size. It has grown around the adrenal glands but has not spread to nearby organs.
T4: Tumors of any size can develop into one of the following:
- Near tissues or organs such as the kidney
- The thin muscles under the lungs and heart that separate the chest and abdomen are called the diaphragm.
- Larger blood vessels, known as the aorta and the vena cava
- Pancreas
- Spleen
- Liver
Node (N)
The “N” in the TNM staging system represents a lymph node. These tiny bean-shaped organs help fight infections. Lymph nodes are found throughout the body. If lymph nodes are near the exit of the tumor are called local lymph nodes. Lymph nodes in other body parts are called distant lymph nodes.
NX: The regional lymph node cannot be evaluated.
N0 (N plus zero): Cancer has not spread to the regional lymph nodes.
N1: Cancer has spread to the regional lymph nodes.
Metastasis (M)
The “M” in the TNM system indicates whether cancer has spread to other parts of the body called metastases.
M0 (M plus zero): Cancer has not spread to other body parts. M1: Cancer has spread beyond nearby organs to other body parts.
Cancer stage grouping
Doctors combine T, N, and M information to map the Stages of Adrenal Gland Tumor and determine the stage 1,2.
Stage I
Tumor is less than 5 cm and does not extend beyond the adrenal glands. It did not spread to regional lymph nodes or other body parts (T1, N0, M0).
Stage II
Tumor larger than 5 cm. It did not grow beyond the adrenal glands or spread to regional lymph nodes or other body parts (T2, N0, M0).
Stage III
The description of the tumor is as follows:
- If it is less than 5 cm and has spread to local lymph nodes but not to other body parts (T1, N1, M0).
- It is more significant than 5 cm and extends to regional lymph nodes but not other body parts (T2, N1, M0).
- It is of any size and has grown beyond the adrenal glands but not in adjacent organs (T3, N0, M0).
Stage IV
The description of the tumor is as follows:
- The tumor is of any size and grows in the area around the adrenal glands but not in the adjacent organs.
- Cancer has spread to regional lymph nodes but not other body parts (T3, N1, M0). It is of any size and extends to adjacent organs but not to lymph nodes or other body parts (T4, N0, M0) beyond adjacent organs. In short, in all sizes, it has spread to nearby organs.
- The tumor has spread to the regional lymph nodes but not to other body parts other than nearby organs (T4, N1, M0).
- Cancer has spread to other body parts (all T, all N, M1).
Recurrence
Recurrent cancer is cancer that has recurred after treatment. When cancer comes back, another test can help to check the level of the recurrence. These tests and scans are shows similarity to those done at the initial diagnosis.
References
- 1.Lattin GE Jr, Sturgill ED, Tujo CA, et al. From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation. RadioGraphics. Published online May 2014:805-829. doi:10.1148/rg.343130127
- 2.Benassai G, Desiato V, Benassai G, et al. Adrenocortical carcinoma: What the surgeon needs to know. Case report and literature review. International Journal of Surgery. Published online August 2014:S22-S28. doi:10.1016/j.ijsu.2014.05.030