Global Consultation on Cancer Staging: promoting consistent understanding and use

Abstract

Disease burden is the most important determinant of survival in patients with cancer. This domain, reflected by the cancer stage and codified using the tumour-node-metastasis (TNM) classification, is a fundamental determinant of prognosis. Accurate and consistent tumour classification is required for the development and use of treatment guidelines and to enable clinical research (including clinical trials), cancer surveillance and control. Furthermore, knowledge of the extent and stage of disease is frequently important in the context of translational studies. Attempts to include additional prognostic factors in staging classifications, in order to facilitate a more accurate determination of prognosis, are often made with a lack of knowledge and understanding and are one of the main causes of the inconsistent use of terms and definitions. This effect has resulted in uncertainty and confusion, thus limiting the utility of the TNM classification. In this Position paper, we provide a consensus on the optimal use and terminology for cancer staging that emerged from a consultation process involving representatives of several major international organizations involved in cancer classification. The consultation involved several steps: a focused literature review; a stakeholder survey ; and a consultation meeting. This aim of this Position paper is to provide a consensus that should guide the use of staging terminology and secure the classification of anatomical disease extent as a distinct aspect of cancer classification.

Upregulation of CCT-3 Induces Breast Cancer Cell Proliferation Through miR-223 Competition and Wnt/β-Catenin Signaling Pathway Activation

“…In order to form a tumor, cells must pass through a multistep process including uncontrolled signaling transduction, energy metabolism, cell growth, and tumor formation (22). These steps are essential, and each step has several barriers, which must be overcome by malignant cells for successful tumor formation.…”

Cancer Classification at the Crossroads

“…Our classification systems have always evolved and will continue to evolve as new scientific data emerge. We must decide if it is appropriate to continue to use the familiar WHO and TNM systems [22] or if it is opportune to define new tumor classes according to the mounting molecular-genetic data, looking to the future.…”

Correlation Between Diagnostic Tests for Laryngeal Cancer Staging and Anatomopathological Staging: A Systematic Review Protocol

“…Staging is a fundamental factor in the establishment of better prognosis and development of cancer surveillance actions and epidemiological studies [9]. Several factors led to its use on a global scale, and over time, other factors were added, such as age and histological grade by type of tumor [14].…”

“…Adequate clinical management is essential to establish a better prognosis, which is directly related to tumor staging. The assessment of preoperative (or clinical) TNM staging requires a set of imaging tests (magnetic resonance imaging, computed tomography, ultrasonography, and endoscopy) that are signi cantly important in clinical management and therapeutic follow-up [9,10]. However, there is no consensus in requesting such tests, and diagnostic accuracy is still a trap in determining preoperative TNM staging compared to postoperative (pathological) staging, a more invasive method [11].…”