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Definition: A malignancy limited to the organ of origin;
no spread beyond organ of origin; infiltration past basement
membrane of epithelium into stroma of organ.
Tumor can be widely invasive or even show metastases within
the organ itself and still be considered "confined to organ
of origin) or localized. Usually a straightforward stage determination
for organs which have definite boundaries (prostate, testis,
stomach, etc.) or sites where there is a clear line between
the organ of origin and the surrounding region. (Exception:
skin)
For internal organs, it is generally impossible to determine
whether tumor is localized without exploratory surgery. However,
the increasing sophistication of many imaging techniques is
predicted to eventually make exploratory surgery obsolete.
Read both pathology reports and operative reports for comments
on gross evidence of spread, microscopic extension and metastases.
Also read diagnostic imaging reports for mention of distant
disease. If path report, operative report and other investigations
show no evidence of spread, tumor may be assumed to be localized.
When staging cases diagnosed clinically only, it is better
to record as "stage not recorded" than "localized" when there
is no other evidence of spread. Recognize the names of different
structures within the organ (such as lamina propria, myometrium,
muscularis) so that reference to invasion of such structures
will not be interpreted as regional spread.
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