Amin MB, Edge SB, Greene FL, et al, eds.AJCC Cancer Staging Manual. 8th ed. NewYork: Springer; 20
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The AJCC Cancer Staging Manual, 8th edition, published by Amin et al., provides standardized criteria for evaluating and staging various types of cancer. The manual allows physicians to assess treatment response and predict prognosis based on the stage of the disease. It incorporates important factors such as tumor size, grade, lymph node involvement, and distant metastasis to determine the stage of the cancer. The manual has been used to construct and validate prognostic nomograms for predicting survival in patients with Nonfunctional Pancreatic neuroendocrine tumor (NF-pNET) . It also provides guidance for the gross dissection procedure in cases of liver resection for hepatocellular carcinoma, ensuring accurate pathology reporting . The 8th edition of the manual introduced changes in the T categorization of oral cavity cancer, incorporating depth of invasion as a prognostic factor . Additionally, it emphasizes the evaluation of extra thyroid extension in locally advanced thyroid cancer for staging and prognosis .
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06 Apr 2021 | The AJCC Cancer Staging Manual is edited by Amin MB, Edge SB, Greene FL, et al and is in its 8th edition. |
| The 8th edition of the AJCC Cancer Staging Manual was published by Amin MB, Edge SB, Greene FL, et al. | |
| The AJCC Cancer Staging Manual, 8th edition, provides standardized criteria for evaluating breast cancer patients and assessing treatment response. |
Related Questions
What is the table of AJCC in defining T, N, and M staging for colorectal patients?4 answersThe American Joint Committee on Cancer (AJCC) staging system for colorectal cancer defines T, N, and M staging as follows: T staging includes Tis for intramucosal adenocarcinoma and T4a for tumors invading the serosal surface, while T4b involves direct invasion of adjacent organs. N staging encompasses N0 for no lymph node involvement, N1 for metastasis in one to three lymph nodes, and N2 divided into N2a (4-6 nodes) and N2b (7 or more nodes). M staging includes M0 for no distant metastases, M1a for metastasis to a single site, and M1b for metastasis to multiple sites. The AJCC system provides a comprehensive framework for prognostication and treatment decisions in colorectal cancer patients, with recent advancements suggesting the potential incorporation of immune infiltrate assessment for improved prognostic accuracy.
How can define survival endpoints in oncology ?4 answersSurvival endpoints in oncology refer to crucial measures of patient outcomes in clinical trials. Overall survival (OS) is considered the gold standard, reflecting patients' longevity and well-being. However, challenges like long-term follow-up and high costs have led to exploring surrogate endpoints like progression-free survival (PFS) and disease-free survival (DFS). These surrogate endpoints, such as PFS, are used as proxies for patient-centered outcomes, predicting therapeutic response and survival gains earlier in the treatment process. The fragility index analysis highlights the importance of robustness in trial results, indicating that small variations could alter the statistical significance of studies using surrogate endpoints. Understanding and defining these survival endpoints are crucial for evaluating treatment benefits and guiding clinical decisions in oncology.
How is clinical staging and histopathological staging performed in oncology?6 answersClinical staging in oncology is a critical process that involves a comprehensive assessment to determine the extent of cancer within the body. This process is pivotal for planning the best surgical or medical treatment and predicting patient prognosis. Clinical staging is achieved through a combination of non-invasive modalities, including the examination of case history, clinical assessments, and radiological tests such as CT and MRI scans, which are the main radiologic techniques for both anatomic diagnosis and staging of cancer. Additionally, 18F-FDG PET/CT is utilized for evaluating the metabolic activity of tumor lesions, with innovative radiotracers like 11C-choline and 68Ga-DOTA compounds being developed for detecting specific cancers.
Histopathological staging, on the other hand, involves the microscopic examination of tissues obtained either through biopsy or surgery. This type of staging is considered more definitive as it provides direct evidence of cancer cells. The process includes evaluating the size of the tumor, its anatomical extent, and the presence or absence of metastatic disease in lymph nodes. For instance, in the case of non-small cell lung cancer (NSCLC), a thorough mediastinal staging, which is part of the histopathological evaluation, is essential for prognostic assessment and therapy planning. Techniques such as sentinel lymph node mapping have been described for more accurate clinical staging, highlighting the evolving nature of histopathological assessments.
Both clinical and histopathological staging methods aim to reconcile to offer a more accurate assessment of cancer's extent and prognosis. Studies have shown a strong correlation between clinical mathematical models and pathology-based staging, emphasizing the importance of integrating these approaches for customized patient treatment plans. Moreover, the development and application of artificial intelligence (AI) in digital pathology promise to enhance the accuracy and efficiency of tumor grading and staging, potentially overcoming the limitations of conventional methods.
In summary, clinical and histopathological staging in oncology are complementary processes that involve a combination of non-invasive assessments and direct tissue examination to accurately determine the extent of cancer, which is crucial for treatment planning and prognosis prediction.
What role does histopathological staging play in the diagnosis and prognosis of cancer patients?9 answersHistopathological staging, particularly the TNM (tumor-node-metastasis) system, is pivotal in the diagnosis and prognosis of cancer patients, serving as the gold standard in oncology for numerous cancers. This system assesses tumor thickness, nodal involvement, and the presence of metastases, which are crucial for determining the stage of cancers such as gastric, esophageal, and oral squamous cell carcinomas. The staging not only influences the treatment decisions but also provides significant prognostic information. For instance, in gastric cancer, the stage at diagnosis greatly affects survival and prognosis, similar to esophageal cancer where the stage directly impacts prognosis and guides staged directed treatment.
Moreover, histopathological evaluation extends beyond staging to include the assessment of tumor grade and other characteristics, which can further refine prognosis predictions and treatment planning. For example, in oral squamous cell carcinomas, a histoscore based on various tumor characteristics can provide additional prognostic information beyond TNM staging. However, the subjective nature of histopathological grading and its limitations due to interobserver variability highlight the potential of artificial intelligence to enhance the prognostic value of pathology images beyond conventional staging and grading.
Histopathology also plays a critical role in the diagnosis and management of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), where tissue analysis is essential for confirming the diagnosis, understanding the prognosis, and making therapy decisions. The integration of histopathology with advanced imaging techniques and molecular genetic analysis is promising for achieving earlier cancer diagnosis, more accurate tumor staging, and personalized follow-up in the precision medicine era.
In summary, histopathological staging is fundamental in the diagnosis and prognosis of cancer patients, guiding treatment decisions and providing crucial prognostic information. The integration of traditional histopathology with advanced technologies and molecular analyses holds the potential to further enhance cancer care.
What are the different staging systems for gastric cancer?4 answersThe different staging systems for gastric cancer include the 8th AJCC staging system, lymph node hybrid staging (hN) system, Metastatic lymph node ratio (LNR) staging system, Kattan Prognostic Tool, Prognostic Tool of Italian Research Group on Gastric Cancer (GIRCG), and the tumor-ratio-metastasis (TRM) staging system. The 8th AJCC staging system divides lymph nodes into different stages based on the number of positive lymph nodes. The hN staging system combines the location and number information of positive lymph nodes to create a novel staging system for gastric cancer. The LNR staging system uses the ratio of metastatic lymph nodes to total examined lymph nodes for staging. The Kattan Prognostic Tool and GIRCG Prognostic Tool are prognostic nomograms used to predict patients' prognosis. The TRM staging system is based on the lymph node ratio and has shown improved discriminatory ability compared to the AJCC TNM staging system.
Cancer, covid 19, staging,5 answersThe impact of the COVID-19 pandemic on cancer staging varied across different studies. One study found that cancer cases staged during the pandemic were not associated with higher stage, suggesting that there was prioritization of cancer procedures during times of reduced capacity. Another study focused on early-onset colorectal cancer (EOCRC) and found that the pandemic influenced the diagnosis and staging of EOCRC patients, with an increase in the rate of metastatic disease and certain pathological features in the post-pandemic group. A retrospective cohort study analyzing multiple cancer types found a decrease in the number of new cases and a shift in clinical stages, with a decrease in advanced cases for lung and kidney cancer, but an increase for thyroid and prostate cancer. Two studies specifically focused on breast cancer (BC) and observed a lower prevalence of early-stage BC and a higher prevalence of advanced-stage BC during the pandemic. These findings suggest that the pandemic had an impact on cancer staging, with variations depending on the cancer type.