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Cancer staging, grading and performance status

Essential points for quick revision.

Synopsis

Distinguish anatomical stage, pathological grade and functional performance status, establish each with the correct evidence, and use them with biology and patient priorities rather than as interchangeable labels.

  • Stage describes anatomical extent, usually primary tumour, regional nodes and distant metastasis; the applicable TNM edition and tumour-specific system must be named.
  • Clinical stage uses examination, imaging and biopsy information before definitive surgery, while pathological stage incorporates resection findings and may be more precise.
  • Grade describes microscopic differentiation, proliferation or tumour-specific biological aggressiveness and is not another word for stage.

Investigation priorities

01
Tumour-specific staging imagingFirst step

Define local, nodal and distant extent before treatment.

Management branches

DefineEstablish baseline extent

Cancer is histologically confirmed or strongly suspected and definitive planning begins.

  1. Name the tumour subtype, staging system and edition, then identify which anatomical findings could change treatment intent.
  2. Complete the site-specific imaging and tissue pathway, confirming equivocal distant lesions when the consequence would be major.
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Sources and review status4 sources · checked 27 Aug 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom