Fact Sheets
Grading & Staging
Understanding the grade and stage of neuroendocrine cancer is crucial in guiding management and developing a treatment plan.
Grading is the description a pathologist gives to neuroendocrine cancer cells when they are viewed under a microscope. The pathologist looks at both the structure of the cell in comparison to a normal cell, and also the growth rate of the neuroendocrine cancer cell.
Staging describes whether the disease is confined to its original site or if it has spread to lymph nodes or other organs of the body.
Grading
Grading for neuroendocrine cancers are based on a variety of factors:
- How slowly or quickly cells are growing and dividing (using both the Ki-67 proliferation index and the mitotic rate)
- Whether the cancer cells are well differentiated (cancer cells that look similar to normal cells)
- Whether the cancer cells are poorly differentiated (cancer cells that look very different to normal cells)
Grading of Neuroendocrine Cancers and Neuroendocrine Tumours (NETs)
Grading of Neuroendocrine Carcinomas (NECs)
Staging
Classifying neuroendocrine cancer into one of the 4 stages is site-specific and should be in the form of the tumour, nodes and metastases (TNM) system ( refer to the 8th edition of the American Joint Committee).
T (Tumour)
Describes how deeply the tumour has grown into the surrounding tissue. A higher number (1 to 4) means it has invaded more deeply.
N (Nodes)
Shows whether nearby lymph nodes contain cancer cells. Numbers range from 0 to 3, indicating the extent of lymph node involvement.
M (Metastasis)
Indicates if the cancer has travelled to distant parts of the body. M0 means no evidence of spread whereas M1 means the cancer has spread to other organs.
Once the T, N, and M values are identified, they are then combined to determine the overall stage, ranging from 1 to 4.
Stage 1
Cancer small, is localised and hasn’t spread to lymph nodes
Stage 2
Cancer has grown into nearby tissue but not into the lymph nodes.
Stage 3
Cancer has spread to the lymph nodes but not to distant parts of the body
Stage 4
The cancer has spread to distant organs or other body parts – this is called metastatic disease.
Next steps
It’s important to note that treatment decisions are made on an individual basis, considering factors such as the tumour’s grade, stage, location, overall health and any other existing health conditions.
A multidisciplinary team will collaborate to develop a comprehensive treatment plan that balances the goal of targeting the cancer while preserving your quality of life.
If you or someone you know is dealing with a neuroendocrine cancer, consulting with medical professionals who specialise in this area will provide the most accurate and personalised guidance.
Helpful Resources
Booklets & Guides
Acronyms & Terminology for Neuroendocrine Cancer Patients
Grading & Staging
Factors Influencing Prognosis in Neuroendocrine Tumours
Grading & Staging
Gastroenteropancreatic NET Grading: Variations and Implications
Grading & Staging
Grading of Pulmonary Neuroendocrine Tumours
Grading & Staging
Ki-67 Proliferation Index in NET Grading
Educational Videos
NETs Under the Microscope – Webinar
Grading & Staging
Neuroendocrine Cancer Biomarkers
Courses
Neuroendocrine Tumour Education Course
Booklets & Guides
