193:
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36:
128:
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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
656:, 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.
255:
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
815:
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
674:
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
779:
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.;
683:
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
666:, 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
272:
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.
312:, 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
276:
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,
467:: 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".
316:
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
411:. 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
161:
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
204:(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
296:
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,
435:), 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
780:
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).
742:
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512:
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652:: 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
46:
559:: 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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345:
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happen not to be present in the slices of tissue viewed, incorrect staging and improper treatment can result.
1613:
1536:
476:
For solid tumors, TNM is by far the most commonly used system, but it has been adapted for some conditions.
498:
285:
75:
640:: cancers are localized to one part of the body. Stage I cancer can be surgically removed if small enough.
607:
Staging. This system uses numerals I, II, III, and IV (plus the 0) to describe the progression of cancer.
904:"An Operative Staging System and a Megavoltage Radiotherapeutic Technic for Cerebellar Medulloblastomas"
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646:: cancers are locally advanced. Stage II cancer can be treated by chemotherapy, radiation, or surgery.
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415:. Furthermore, researchers hope that this same technique can be applied to other tissue-specific
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529:). More recently, colon cancer staging is indicated either by the original A-D stages or by TNM.
1494:
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816:(2007). "Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update".
515:" system has been adopted into the TNM system. For premalignant dysplastic changes, the CIN (
400:
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192:
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625:
508:
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Systems of staging may differ between diseases or specific manifestations of a disease.
300:
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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220:
to remove the tumor. This stage may include information about the tumor obtained by
1471:
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Cancer staging can be divided into a clinical stage and a pathologic stage. In the
264:
which shrink the tumor, so the pathologic stage may underestimate the true stage.
174:
it has spread to (if any), and whether it has appeared in more distant locations (
1587:
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483:: For most brain cancers, no staging systems are available and they are instead
243:
Pathologic stage adds additional information gained by examination of the tumor
1509:
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604:
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New, highly sensitive methods of staging are in development. For example, the
216:
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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363:. Statements consisting only of original research should be removed.
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1417:
1195:"Staging: Questions and Answers" at the National Cancer Institute
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439:, which has the same definitions of individual categories as the
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3D medical illustration depicting the TNM stages in breast cancer
596:
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are staged following a classification developed by Chang et al.
404:
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902:
Chang, Chu H.; Housepian, Edgar M.; Herbert, Charles (1969).
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Pathologic staging, where a pathologist examines sections of
163:
427:
Staging systems are specific for each type of cancer (e.g.,
1267:
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525:: originally consisted of four stages: A, B, C, and D (the
392:
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782:"Breast cancer. Clinical practice guidelines in oncology"
685:
1141:. National Comprehensive Cancer Network. Archived from
148:
Determining the extent to which a cancer has developed
950:"Breast Cancer Treatment - National Cancer Institute"
901:
881:. International Agency for Research on Cancer. 2021.
743:"Five Things Physicians and Patients Should Question"
786:
Journal of the
National Comprehensive Cancer Network
157:
is the process of determining the extent to which a
27:Process of determining the extent of cancer spread
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624:Stage 0 can also mean no remaining cancer after
1049:. Cancerhelp.org.uk. 2010-07-28. Archived from
1024:. Cancerhelp.org.uk. 2010-06-30. Archived from
403:, can be identified using molecular screening (
603:Overall Stage Grouping is also referred to as
60:Please review the contents of the article and
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379:Learn how and when to remove this message
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972:"FIGO staging of cervical carcinomas"
757:American Society of Clinical Oncology
739:American Society of Clinical Oncology
251:after it has been surgically removed.
181:
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571:: uses TNM along with a measure of
324:
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565:: TNM almost universally used.
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62:add the appropriate references
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1537:Clonally transmissible cancer
1114:"malignant melanoma: staging"
1072:"How is liver cancer staged?"
854:"Hodgkin's Disease - Staging"
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359:the claims made and adding
47:reliable medical references
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1568:Index of oncology articles
830:10.1016/j.juro.2007.03.003
422:
282:professional organizations
210:hematological malignancies
185:
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1022:"Stages of kidney cancer"
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144:
139:
53:or relies too heavily on
997:"Colon Cancer - Staging"
952:. Cancer.gov. 2010-08-13
579:Non-melanoma skin cancer
471:
449:
1490:Prostate cancer staging
1454:Paraneoplastic syndrome
1172:American Cancer Society
1164:"Bladder Cancer Stages"
799:10.6004/jnccn.2009.0012
1528:Tumor suppressor genes
1495:Gleason grading system
1449:Precancerous condition
818:The Journal of Urology
709:"Cancer Staging - NCI"
690:Will Rogers phenomenon
628:in some cancers (e.g.
626:preoperative treatment
600:
592:Overall stage grouping
197:
1547:Carcinogenic bacteria
1287:Malignant progression
662:: cancers have often
599:
409:colorectal metaplasia
401:intestinal epithelium
195:
1614:Anatomical pathology
1500:Dukes classification
539:Cancer of the larynx
527:Dukes staging system
222:physical examination
1319:Sentinel lymph node
1367:Respiratory system
684:(e.g., the use of
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344:possibly contains
198:
188:TNM staging system
182:TNM staging system
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1583:Cancer and nausea
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1299:Carcinoma in situ
920:10.1148/93.6.1351
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630:colorectal cancer
569:Testicular cancer
460:Ann Arbor staging
389:
388:
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346:original research
279:medical specialty
262:radiation therapy
152:
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1074:. Archived from
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76:"Cancer staging"
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1145:on 2015-10-25
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1120:on 2010-07-18
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1230:Overview of
1175:. Retrieved
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664:metastasized
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545:Liver cancer
523:Colon cancer
481:Brain cancer
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258:chemotherapy
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206:brain tumors
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176:metastasized
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51:verification
44:
1578:Cancer pain
1518:Cancer cell
1263:Hyperplasia
1177:29 December
587:: uses TNM.
581:: uses TNM.
573:blood serum
553:: uses TNM.
551:Lung cancer
547:: Uses TNM.
541:: Uses TNM.
535:: uses TNM.
458:: most use
433:lung cancer
369:August 2024
249:pathologist
226:blood tests
172:lymph nodes
45:needs more
1603:Categories
1523:Carcinogen
1387:Urogenital
1328:Topography
1309:Metastasis
1273:Pseudocyst
1247:Conditions
1168:Cancer.org
1149:2015-11-01
1124:2010-10-14
1082:2013-06-02
1057:2010-10-14
1032:2010-10-14
1007:2010-10-14
982:2010-10-14
956:2010-10-14
864:2010-10-14
770:August 14,
719:2024-09-25
696:References
616:carcinoma
353:improve it
319:lymph node
304:Pathologic
294:bone scans
230:radiologic
87:newspapers
1542:Oncovirus
1532:oncogenes
1485:Ann Arbor
1428:Papilloma
1413:Carcinoma
1406:Histology
1350:laryngeal
1294:Dysplasia
1278:Hamartoma
1102:eMedicine
928:0033-8419
908:Radiology
775:, citing
650:Stage III
413:prognosis
395:for GCC (
357:verifying
286:PET scans
238:endoscopy
117:June 2015
1563:Research
1423:Blastoma
1240:oncology
838:17509297
808:19200416
668:terminal
660:Stage IV
644:Stage II
557:Melanoma
456:Lymphoma
417:proteins
290:CT scans
1573:History
1472:grading
1468:Staging
1433:Adenoma
1418:Sarcoma
936:4983156
638:Stage I
618:in situ
612:Stage 0
511:: the "
423:Systems
351:Please
218:surgery
145:Purpose
101:scholar
66:removed
1304:Cancer
1236:cancer
1232:tumors
934:
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485:graded
405:RT-PCR
310:tissue
236:, and
234:biopsy
168:organs
159:cancer
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1556:Misc.
1442:Other
1382:Blood
764:(PDF)
746:(PDF)
497:: In
472:Solid
450:Blood
292:, or
247:by a
164:tumor
108:JSTOR
94:books
1588:Diet
1377:Skin
1372:Bone
1340:oral
1268:Cyst
1238:and
1179:2017
932:PMID
924:ISSN
883:ISBN
834:PMID
804:PMID
772:2012
513:FIGO
441:AJCC
437:UICC
431:and
393:mRNA
314:cell
260:and
208:and
80:news
49:for
1480:TNM
1100:at
916:doi
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686:MRI
503:TNM
355:by
202:TNM
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