Certified Tumor Registrar (CTR) Practice Exam

Which pathological staging system is based on the resection of the tumor and measures the depth of invasion through the mucosa and bowel wall?

1. Ann Arbor

2. Breslow's depth of invasion

3. Duke's

4. Whitmore

The correct answer is: Duke's

The Duke's staging system is specifically designed for colorectal cancers and evaluates the extent of the tumor based on pathological findings after resection. This system predominantly focuses on the depth of invasion of the tumor into the bowel wall as well as its involvement with the surrounding tissues. The classification in the Duke's system incorporates criteria such as whether the tumor has invaded the muscularis propria, whether there is involvement of nearby lymph nodes, and the presence of metastatic disease. By assessing these factors, the Duke's staging provides crucial information regarding prognosis and helps guide treatment decisions. In contrast, the Ann Arbor system is primarily used for staging lymphomas and does not evaluate depth of invasion in the same manner. Breslow's depth is used specifically for melanoma to measure the depth of tumor invasion in the skin, but not for bowel pathology. Whitmore, on the other hand, pertains to the staging of bladder cancer and does not apply to the resection of bowel tumors. Therefore, Duke's staging is the appropriate choice for a pathological staging system related to the depth of invasion of a gastrointestinal tumor.