Updated 27 April 2011

Staging Diagram and TNM Classification

Investigations for Staging

Once histologic diagnosis and location of the rectal cancer have been established, appropriate management of rectal cancer depends upon accurate preoperative staging. The extent of local disease should be assessed by digital rectal examination and one of endorectal ultrasound, CT scan, or MRI in order to provide essential information about the extent of local invasion and the likelihood of positive mesorectal nodes.

Examination of the entire colon is needed to exclude synchronous cancers or polyps. A metastatic survey should include chest X-ray and abdominal ultrasound or CT scan. A pre-operative CT scan is often helpful to plan pre or post-operative radiotherapy.