CTR Staging & Prognostic Factors 2 — Questions and Answers
Question 1: In the AJCC staging system, what does the 'N' category specifically describe?
- Tumor size and local invasion
- Regional lymph node involvement (Correct answer)
- Presence of distant metastases
- Nuclear grade of the tumor
Correct answer: Regional lymph node involvement
The 'N' category in TNM staging describes the extent of regional lymph node involvement.
Question 2: A tumor staged as pT2 pN1 cM0 uses which type of staging assessment for the N category?
- Pathologic
- Clinical (Correct answer)
- Autopsy
- Recurrence
Correct answer: Clinical
The lowercase 'c' prefix before M0 indicates a clinical (non-pathologic) assessment was used for that category.
Question 3: Which prognostic factor is used specifically for breast cancer staging and reflects tumor cell proliferation rate?
- PSA level
- Ki-67 index (Correct answer)
- CEA level
- AFP level
Correct answer: Ki-67 index
Ki-67 index measures the proportion of actively dividing tumor cells and is a key proliferation marker in breast cancer prognosis.
Question 4: Stage grouping of 'Stage 0' in most AJCC cancer sites refers to which condition?
- Occult primary tumor
- In situ carcinoma with no invasion (Correct answer)
- Microinvasive disease
- Tumor with unknown nodal status
Correct answer: In situ carcinoma with no invasion
Stage 0 represents carcinoma in situ, where abnormal cells are present but have not invaded surrounding tissue.
Question 5: When staging a primary tumor with satellite nodules in the same lobe of the lung, how are those nodules classified in AJCC 8th edition?
- Separate primary tumors (M1)
- T3 designation (Correct answer)
- N1 regional nodes
- Incidental finding, not staged
Correct answer: T3 designation
Separate tumor nodule(s) in the same lobe as the primary are classified as T3 in the AJCC 8th edition lung chapter.
Question 6: What is the purpose of the 'y' prefix in TNM staging (e.g., ypT2)?
- Indicates youthful patient age at diagnosis
- Staging performed after neoadjuvant therapy (Correct answer)
- Confirms the tumor is a recurrence
- Denotes a synchronous second primary
Correct answer: Staging performed after neoadjuvant therapy
The 'y' prefix indicates that the TNM classification was performed after neoadjuvant (preoperative) systemic or radiation therapy.
Question 7: For colorectal cancer, which Dukes classification corresponds to AJCC Stage III?
- Dukes A
- Dukes B
- Dukes C (Correct answer)
- Dukes D
Correct answer: Dukes C
Dukes C corresponds to regional lymph node involvement, which aligns with AJCC Stage III colorectal cancer.
CTR Staging & Prognostic Factors 2
In the AJCC staging system, what does the 'N' category specifically describe?