Clinical, radiological and pathological staging of gastrointestinal cancer

Staging is the process that determines the spread of a malignant tumour, thereby providing prognostic information. It can be assessed by clinical, radiological and pathological means. Before accurate staging is undertaken, a diagnosis of cancer is required, which is usually made by histological examination of biopsy material; this may include imaging techniques to localize and sample the lesion. Once a diagnosis of malignancy is established, the extent of local invasion and the presence of distant metastases must be determined; this is usually undertaken using imaging methods. This contribution discusses the TNM system, staging of oesophageal and gastric carcinoma, staging of carcinoma of the small intestine, and staging of carcinoma of the anal region.