Working PNM Classification and staging Working PNM Classification and staging
P
NM Classification: describing the anatomical extent of AEbased on the assessment of 3 components at the time of diagnosis.
|
P = HEPATIC LOCALIZATION OF THE PARASITE |
N = EXTRAHEPATIC INVOLVEMENT OF NEIGHBOURING ORGANS |
|
M = ABSENCE OR PRESENCE OF DISTANT METASTASIS |
||||
|
P0= |
No detectable tumor in the liver |
[diaphragm, lung, pleura, pericardium, heart, gastric and duodenal wall, adrenal glands, peritoneum, retroperitoneum, parietal wall (muscles, skin, bone), pancreas, regional lymph nodes, liver ligaments] |
(characterizing distant parasitic tumors: lung, distant lymph nodes, spleen, CNS, orbital, bone, muscles, skin, distant peritoneum and retroperitoneum) |
||||
|
P1= |
Peripheral lesions without proximal vascular and/or biliary involvement |
||||||
|
P2= |
Central lesions with proximal vascular and/or biliary involvement of one lobe |
|
X = |
not evaluable |
X = |
not completely evaluated |
|
|
P3= |
Central lesions with hilar vascular and biliary involvement of both lobes and/or with involvement of two hepatic veins |
|
0 = |
no regional involvement |
|
0 = |
no metastasis(negative chest-x-ray and negative cerebral CT) |
|
P4= |
Any liver lesion with extension along the vessels and the biliary tree |
|
1 = |
regional involvement of contiguous organs or tissue |
|
1 = |
metastasis |
STAGING FOR P
NM Classification|
Stage I |
P1 |
N0 |
M0 |
|
Stage II |
P2 |
N0 |
M0 |
|
Stage IIIa |
P3 |
N0 |
M0 |
|
Stage IIIb |
P1-3 P4 |
N1 N0 |
M0 M0 |
|
Stage IV |
P4 P1-4 |
N1 N0-1 |
M0 M1 |