# Tumours Staging —RECTAL IMPORTANT POINTS FOR REVIEW 1. Tumour height (from …

# Tumours Staging —RECTAL
IMPORTANT POINTS FOR REVIEW

1. Tumour height (from dentate line).
2. Tumour position relating to anterior peritoneal
reflection
3. T staging of tumour, is it breaching the wall of the
rectum (T3) and if so by how much?
4. How far from the mesorectal fascia (MSF) is the
tumour? If 1 mm or greater from the MRF ?
5. Is there nodal involvement and if so is an involved
node within 1 mm of the MRF?
6. Are the levator muscles involved?
7. Is there involvement of adjacent organs, e.g. vagina/
bladder/prostate?
8. Is there pelvic side wall lymphadenopathy?

NOTE….Dentate line is not seen on MRI so divide the anal canal into three parts. upper 1/3rd and lower 2/3rd . this junction is the approximate dentate line. Any tumour with an epicentre more than 2cm superior to this line is considered low rectal .

tumours below dentate line drain into inguinal , femoral LN above dentate line drain into perirectal and internal iliac group

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