182:
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obtained by making indirect observations of a tumor which is still in the body. However, clinical staging and pathologic staging often complement each other. Not every tumor is treated surgically, so pathologic staging is not always available. Also, sometimes surgery is preceded by other treatments such as
645:, Stage II indicates affected lymph nodes on only one side of the diaphragm, whereas Stage III indicates affected lymph nodes above and below the diaphragm. The specific criteria for Stages II and III therefore differ according to diagnosis. Stage III can be treated by chemotherapy, radiation, or surgery.
244:
Because they use different criteria, clinical stage and pathologic stage often differ. Pathologic staging is usually considered to be more accurate because it allows direct examination of the tumor in its entirety, contrasted with clinical staging which is limited by the fact that the information is
804:
Thompson, I.; Thrasher, J. B.; Aus, G.; Burnett, A. L.; Canby-Hagino, E. D.; Cookson, M. S.; d'Amico, A. V.; Dmochowski, R. R.; Eton, D. T.; Forman, J. D.; Goldenberg, S. L.; Hernandez, J.; Higano, C. S.; Kraus, S. R.; Moul, J. W.; Tangen, C. M.; AUA Prostate Cancer
Clinical Guideline Update Panel
663:
Within the TNM system, a cancer may also be designated as recurrent, meaning that it has appeared again after being in remission or after all visible tumor has been eliminated. Recurrence can either be local, meaning that it appears in the same location as the original, or distant, meaning that it
768:
Carlson, R. W.; Allred, D. C.; Anderson, B. O.; Burstein, H. J.; Carter, W. B.; Edge, S. B.; Erban, J. K.; Farrar, W. B.; Goldstein, L. J.; Gradishar, W. J.; Hayes, D. F.; Hudis, C. A.; Jahanzeb, M.; Kiel, K.; Ljung, B. M.; Marcom, P. K.; Mayer, I. A.; McCormick, B.; Nabell, L. M.; Pierce, L. J.;
672:
Stage migration is a change in the distribution of stages in a particular cancer population, induced by either a change in the staging system itself or else a change in technology which allows more sensitive detection of tumor spread and therefore more sensitivity in detecting spread of disease
655:, or spread to other organs or throughout the body. Stage IV cancer can be treated by chemotherapy, radiation, or surgery. Despite treatment, a patient's mortality rate can be significantly higher with Stage IV cancer, e.g., the cancer can progress to become
261:
Correct staging is critical because treatment (particularly the need for pre-operative therapy and/or for adjuvant treatment, the extent of surgery) is generally based on this parameter. Thus, incorrect staging would lead to improper treatment.
301:, can be particularly problematic for two specific reasons: visual discretion and random sampling of tissue. "Visual discretion" means being able to identify single cancerous cells intermixed with healthy cells on a slide. Oversight of one
265:
For some common cancers the staging process is well-defined. For example, in the cases of breast cancer and prostate cancer, doctors routinely can identify that the cancer is early and that it has low risk of metastasis. In such cases,
456:: follows a scale from I to IV and can be indicated further by an A or B, depending on whether a patient is non-symptomatic or has symptoms such as fevers. It is known as the "Cotswold System" or "Modified Ann Arbor Staging System".
305:
can mean misstaging and lead to serious, unexpected spread of cancer. "Random sampling" refers to the fact that lymph nodes are cherry-picked from patients and random samples are examined. If cancerous cells present in the
400:. Because of its high sensitivity, RT-PCR screening for GCC greatly reduces underestimation of disease stage. Researchers hope that staging with this level of precision will lead to more appropriate treatment and better
150:
has grown and spread. A number from I to IV is assigned, with I being an isolated cancer and IV being a cancer that has metastasized and spread from its origin. The stage generally takes into account the size of a
193:(Tumor, Node, Metastasis) system, clinical stage and pathologic stage are denoted by a small "c" or "p" before the stage (e.g., cT3N1M0 or pT2N0). This staging system is used for most forms of cancer, except
285:
because research shows that the risk of getting such procedures outweighs the possible benefits. Some of the problems associated with overtesting include patients receiving invasive procedures,
424:), but some cancers do not have a staging system. Although competing staging systems still exist for some types of cancer, the universally-accepted staging system is that of the
769:
Reed, E. C.; Smith, M. L.; Somlo, G.; Theriault, R. L.; Topham, N. S.; Ward, J. H.; Winer, E. P.; Wolff, A. C.; NCCN Breast Cancer
Clinical Practice Guidelines Panel (2009).
731:
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501:
1060:
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641:: cancers are also locally advanced. Whether a cancer is designated as Stage II or Stage III can depend on the specific type of cancer; for example, in
35:
548:: TNM used. Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion ("Microstaging").
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334:
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happen not to be present in the slices of tissue viewed, incorrect staging and improper treatment can result.
1602:
1525:
465:
For solid tumors, TNM is by far the most commonly used system, but it has been adapted for some conditions.
487:
274:
64:
629:: cancers are localized to one part of the body. Stage I cancer can be surgically removed if small enough.
596:
Staging. This system uses numerals I, II, III, and IV (plus the 0) to describe the progression of cancer.
893:"An Operative Staging System and a Megavoltage Radiotherapeutic Technic for Cerebellar Medulloblastomas"
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635:: cancers are locally advanced. Stage II cancer can be treated by chemotherapy, radiation, or surgery.
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518:). More recently, colon cancer staging is indicated either by the original A-D stages or by TNM.
1483:
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805:(2007). "Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update".
504:" system has been adopted into the TNM system. For premalignant dysplastic changes, the CIN (
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181:
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Systems of staging may differ between diseases or specific manifestations of a disease.
289:
medical services, getting unnecessary radiation exposure, and experiencing misdiagnosis.
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scans). Stage migration can lead to curious statistical phenomena (for example, the
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to remove the tumor. This stage may include information about the tumor obtained by
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189:
Cancer staging can be divided into a clinical stage and a pathologic stage. In the
253:
which shrink the tumor, so the pathologic stage may underestimate the true stage.
163:
it has spread to (if any), and whether it has appeared in more distant locations (
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472:: For most brain cancers, no staging systems are available and they are instead
232:
Pathologic stage adds additional information gained by examination of the tumor
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New, highly sensitive methods of staging are in development. For example, the
205:
Clinical stage is based on all of the available information obtained before a
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if you can. Unsourced or poorly sourced material may be challenged and
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352:. Statements consisting only of original research should be removed.
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1406:
1184:"Staging: Questions and Answers" at the National Cancer Institute
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428:, which has the same definitions of individual categories as the
206:
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3D medical illustration depicting the TNM stages in breast cancer
585:
1292:
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are staged following a classification developed by Chang et al.
393:
222:
147:
891:
Chang, Chu H.; Housepian, Edgar M.; Herbert, Charles (1969).
767:
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Pathologic staging, where a pathologist examines sections of
152:
416:
Staging systems are specific for each type of cancer (e.g.,
1256:
1218:
514:: originally consisted of four stages: A, B, C, and D (the
381:
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771:"Breast cancer. Clinical practice guidelines in oncology"
674:
1130:. National Comprehensive Cancer Network. Archived from
137:
Determining the extent to which a cancer has developed
939:"Breast Cancer Treatment - National Cancer Institute"
890:
870:. International Agency for Research on Cancer. 2021.
732:"Five Things Physicians and Patients Should Question"
775:
Journal of the
National Comprehensive Cancer Network
146:
is the process of determining the extent to which a
16:Process of determining the extent of cancer spread
1589:
613:Stage 0 can also mean no remaining cancer after
1038:. Cancerhelp.org.uk. 2010-07-28. Archived from
1013:. Cancerhelp.org.uk. 2010-06-30. Archived from
392:, can be identified using molecular screening (
592:Overall Stage Grouping is also referred to as
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494:, but staging in I–IV may be used as well.
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368:Learn how and when to remove this message
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739:Choosing Wisely: an initiative of the
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961:"FIGO staging of cervical carcinomas"
746:American Society of Clinical Oncology
728:American Society of Clinical Oncology
240:after it has been surgically removed.
170:
1105:. Chorus.rad.mcw.edu. Archived from
1036:"The stages of cancer of the larynx"
317:
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963:. Screening.iarc.fr. Archived from
560:: uses TNM along with a measure of
313:
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155:, whether it has invaded adjacent
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1128:"NCCN Guidelines for Patients"
1086:Imaging in Lung Cancer Staging
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554:: TNM almost universally used.
490:, staging is usually based on
51:add the appropriate references
1:
1526:Clonally transmissible cancer
1103:"malignant melanoma: staging"
1061:"How is liver cancer staged?"
843:"Hodgkin's Disease - Staging"
684:
292:
273:recommend against the use of
159:, how many regional (nearby)
498:Cervical and ovarian cancers
488:breast cancer classification
476:. Embryonal CNS tumors like
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348:the claims made and adding
36:reliable medical references
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1619:
1557:Index of oncology articles
819:10.1016/j.juro.2007.03.003
411:
271:professional organizations
199:hematological malignancies
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1011:"Stages of kidney cancer"
959:Eric Lucas (2006-01-31).
508:) grading system is used.
133:
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42:or relies too heavily on
986:"Colon Cancer - Staging"
941:. Cancer.gov. 2010-08-13
568:Non-melanoma skin cancer
460:
438:
1479:Prostate cancer staging
1443:Paraneoplastic syndrome
1161:American Cancer Society
1153:"Bladder Cancer Stages"
788:10.6004/jnccn.2009.0012
1517:Tumor suppressor genes
1484:Gleason grading system
1438:Precancerous condition
807:The Journal of Urology
698:"Cancer Staging - NCI"
679:Will Rogers phenomenon
617:in some cancers (e.g.
615:preoperative treatment
589:
581:Overall stage grouping
186:
1536:Carcinogenic bacteria
1276:Malignant progression
651:: cancers have often
588:
398:colorectal metaplasia
390:intestinal epithelium
184:
1603:Anatomical pathology
1489:Dukes classification
528:Cancer of the larynx
516:Dukes staging system
211:physical examination
1308:Sentinel lymph node
1356:Respiratory system
673:(e.g., the use of
590:
386:guanylyl cyclase c
333:possibly contains
187:
177:TNM staging system
171:TNM staging system
1585:
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1572:Cancer and nausea
1451:
1450:
1288:Carcinoma in situ
909:10.1148/93.6.1351
643:Hodgkin's Disease
619:colorectal cancer
558:Testicular cancer
449:Ann Arbor staging
378:
377:
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335:original research
268:medical specialty
251:radiation therapy
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1063:. Archived from
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903:(6): 1351–1359.
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1134:on 2015-10-25
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32:This article
30:
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1456:
1219:Overview of
1164:. Retrieved
1156:
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1111:. Retrieved
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704:. 2015-03-09
701:
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662:
653:metastasized
648:
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534:Liver cancer
512:Colon cancer
470:Brain cancer
464:
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247:chemotherapy
243:
195:brain tumors
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165:metastasized
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40:verification
33:
1567:Cancer pain
1507:Cancer cell
1252:Hyperplasia
1166:29 December
576:: uses TNM.
570:: uses TNM.
562:blood serum
542:: uses TNM.
540:Lung cancer
536:: Uses TNM.
530:: Uses TNM.
524:: uses TNM.
447:: most use
422:lung cancer
358:August 2024
238:pathologist
215:blood tests
161:lymph nodes
34:needs more
1592:Categories
1512:Carcinogen
1376:Urogenital
1317:Topography
1298:Metastasis
1262:Pseudocyst
1236:Conditions
1157:Cancer.org
1138:2015-11-01
1113:2010-10-14
1071:2013-06-02
1046:2010-10-14
1021:2010-10-14
996:2010-10-14
971:2010-10-14
945:2010-10-14
853:2010-10-14
759:August 14,
708:2024-09-25
685:References
605:carcinoma
342:improve it
308:lymph node
293:Pathologic
283:bone scans
219:radiologic
76:newspapers
1531:Oncovirus
1521:oncogenes
1474:Ann Arbor
1417:Papilloma
1402:Carcinoma
1395:Histology
1339:laryngeal
1283:Dysplasia
1267:Hamartoma
1091:eMedicine
917:0033-8419
897:Radiology
764:, citing
639:Stage III
402:prognosis
384:for GCC (
346:verifying
275:PET scans
227:endoscopy
106:June 2015
1552:Research
1412:Blastoma
1229:oncology
827:17509297
797:19200416
657:terminal
649:Stage IV
633:Stage II
546:Melanoma
445:Lymphoma
406:proteins
279:CT scans
1562:History
1461:grading
1457:Staging
1422:Adenoma
1407:Sarcoma
925:4983156
627:Stage I
607:in situ
601:Stage 0
500:: the "
412:Systems
340:Please
207:surgery
134:Purpose
90:scholar
55:removed
1293:Cancer
1225:cancer
1221:tumors
923:
915:
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825:
795:
474:graded
394:RT-PCR
299:tissue
225:, and
223:biopsy
157:organs
148:cancer
92:
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1545:Misc.
1431:Other
1371:Blood
753:(PDF)
735:(PDF)
486:: In
461:Solid
439:Blood
281:, or
236:by a
153:tumor
97:JSTOR
83:books
1577:Diet
1366:Skin
1361:Bone
1329:oral
1257:Cyst
1227:and
1168:2017
921:PMID
913:ISSN
872:ISBN
823:PMID
793:PMID
761:2012
502:FIGO
430:AJCC
426:UICC
420:and
382:mRNA
303:cell
249:and
197:and
69:news
38:for
1469:TNM
1089:at
905:doi
815:doi
811:177
783:doi
681:).
675:MRI
492:TNM
344:by
191:TNM
167:).
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