In determining a patient’s cancer staging, a physician must first determine the type of cancer. While there are many different staging systems, the TNM system is the most commonly used. In most cases, a cancer is classified using the TNM system for cancers that have spread outside of the body. Different cancer staging systems are used for different types of cancer, such as blood cancers. In some cases, the cancer staging system used is not even clear.
The AJCC cancer staging manual’s eighth edition reflects a major shift in mission. It bridges the traditional population-based approach to cancer staging with the newer molecular approach. The TNM system was first published in 1977, and its eighth edition incorporates the use of the TNM classification system. Although the AJCC hasn’t formally changed its classification system, its changes in content and scope mark a landmark in the field of pathology.
In addition, the AJCC has incorporated prognostic stage groups into the classification system. This merges the concept of anatomic stage and prognostic stage groups and makes staging more patient-centered. Furthermore, the new edition’s detailed discussion of prognostic factors expands the clinically relevant cancer signature. The text describes prognostic factors from three points of view, including emerging and established factors. Each point of view has distinct ramifications.
The most recent changes to the TNM classification include the inclusion of HPV in oropharyngeal carcinoma, separate systems for the stomach, and the addition of an “H” category to TNM for retinoblastoma. These changes are intended to incorporate the powerful effects of hereditary cancer on the prognosis. Cancer staging systems may be confusing and can cause conflicting reports. For this reason, the experts’ opinions are highly subjective.
TNM is updated every few years, and new scientific data have improved the accuracy of this method. Tumors that are located at the esophagogastric junction or in the stomach within five cm of it are categorized as esophageal cancer. Therefore, cancers staged T1a and T1b are often characterized as esophageal cancer. A recent study also demonstrated that tumors that are within five centimeters from the junction of the esophagus and the stomach are categorized as gastric cancer.
The new algorithm can use histological data in medical reports without coding and has the added benefit of being able to use retrospective data. The algorithm can be applied to patients with limited expert knowledge or if there is no expert information available. The research authors report that they have performed a literature review on medical text categorization. This method is used to identify which documents belong to predefined classifications. If the algorithm finds a document that falls within one of these categories, it can classify it as such.
In the 8th AJCC prognostic staging, Black patients and white patients were both staged as stage IIIA. The Will Rogers phenomenon has been cited as one of the most important biases in historical cohorts. While these results are important, it is vital to recognize that the Will Rogers effect is present in clinical trials. A more accurate staging system can increase patients’ chances of surviving the disease. And a more detailed prognosis will help the doctors decide which treatment option is best for their patients.
