[Verse 1]
Alright, pull up the textbook, crack the spine and comprehend
Three staging systems, every surgeon needs to tend
AJCC eighth edition, that's the modern standard bearer
TNM notation, let me make the logic clearer
T is for the tumour, how deep it's burrowed through
N captures nodes involved, M tells metastasis too
Gastric cancer starts at T1a, mucosa's where it hides
T1b hits the submucosa, each layer subdivides
T2 hits muscularis, T3 breaks the subserosa
T4a perforates the visceral peritoneum, getting closer
T4b invades adjacent structures — that's the stage that chills
Eight regional nodes negative means N0 sits still
[Chorus]
Drei Systeme, wir lernen sie genau —
TNM, das Japanische, und Dukes dazu
T, N, M — wie tief, wie viel, wie weit
Staging präzise — surgical clarity
[Verse 2]
Small bowel cancer mirrors gastric, similar T progression
Colon and rectal differ slightly, pay attention to the session
Rectal T3 subdivides by millimetres — mesorectal spread
Less than one, one to five, beyond fifteen — radiologists' thread
N1 means one to three nodes, N1c is tumour deposit
N2 is four or more nodes, now the prognosis — oppose it
Anal canal uses different staging, squamous cell domain
T1 under two centimetres, T4 invades adjacent terrain
Appendiceal tumours — mucinous versus non, a separate chapter
Low-grade versus high-grade, peritoneal spread captured
[Chorus]
Drei Systeme, wir lernen sie genau —
TNM, das Japanische, und Dukes dazu
T, N, M — wie tief, wie viel, wie weit
Staging präzise — surgical clarity
[Verse 3]
Now the Japanese Classification — Tokyo's meticulous eye
Gastric cancer mapped by thirds: proximal, middle, and the distal tie
Upper third gets U, middle gets M, lower portion is L
Posterior wall, anterior, lesser curve — detail you must tell
Growth patterns coded: Bormann type one through four, macroscopic face
Type one's polypoid, four is diffuse infiltration taking space
Deeper dive than AJCC — lymph node stations numbered clear
D1 resection, D2 dissection — each station engineered
This taxonomic granularity — that rare word means
The fineness of detail, classification carved to extreme
Japanese surgeons catalogued each node with lapidary care
The way a gem-cutter scores a diamond — nothing spare
[Bridge]
Dukes from nineteen thirty-two — colon cancer's elder name
A, B, C confined or nodal, Dukes C bleeds to shame
Astler-Coller modified it, split the B and C in two
B1 stays in muscularis, B2 breaks through
C1 nodes involved but within the wall
C2 nodes plus full-thickness — Dukes foresaw it all
Historical weight, we honour it but AJCC now reigns
Superseded but the logic lives inside our training veins
[Chorus]
Drei Systeme, wir lernen sie genau —
TNM, das Japanische, und Dukes dazu
T, N, M — wie tief, wie viel, wie weit
Staging präzise — surgical clarity