Role of Helicobacter pylori in gastric mucosa-associated lymphoid tissue lymphomas

Table 5 Comparison of four frequently used staging systems for primary gastrointestinal lymphomas

Tissue invasion	Ann arbor	Radaszkiewicz	Lugano	Paris
Gastrointestinal tract	IE	IE	I	T1 N0 M0
Mucosa or submucosa	IE	IE1	I	T1 N0 M0
Mucosa	IE	IE1	I	T1m N0 M0
Submucosa	IE	IE1	I	T1sm N0 M0
Muscularis propria or subserosa	IE	IE2	I	T2 N0 M0
Serosa	IE	IE2	I	T3 N0 M0
Intra-abdominal extension			II
Adjacent tissues or organs	IE	IE	IIE	T4 N0 M0
Regional lymph nodes	IIE	IIE	II1	T1 N1 M0
Infradiaphragmatic distal lymph nodes	IIE	IIE	II2	T1 N2 M0
Disseminated disease			IV
Supradiaphragmatic lymph nodes	IIIE	IIIE	IV	T1 N3 M0
Non-contiguous gastrointestinal2	IVE	IVE	IV	T1 N1 M1
Non-contiguous metastasis3	IVE	IVE	IV	T1 N1 M2
Marrow involvement	IVE	IVE	IVE	T1 N1 M1B1

In the case of synchronous lesions originating in the gastrointestinal tract, staging refers to the characteristics of the most advanced lesion. Note that the Lugano system does not include a stage III.

¹Any subtype of tumor extension (T1 to T4) or nodal (N0 to N3) or metastatic (M0 to M2) involvement;

²Non-contiguous gastrointestinal involvement refers to the presence of lymphoma in more than one gastrointestinal site with segments of discontinuity that are free of disease (such as the involvement of the stomach and rectum, with a free small intestine and bowel);

³Including the non-contiguous involvement of the peritoneum. References for the 4 staging systems are given in the main text.