AJCC Cancer Staging Manual 8th Edition PDF
55.90 MB PDF
Cáncer staging plays a pivotal role in the battle against cáncer. First and foremost, staging provides patients with cáncer and their physicians the critical benchmark and standards for defining prognosis, the likelihood of overcoming the cáncer once diagnosed, and for determining the best treatment approach for the disease. Staging also forms the basis for understanding the changes in population cáncer incidence, the extent of disease at initial presentation, and the overall impact of improvements in cáncer treatment. Staging is the foremost classifier of cáncer patients and defines groups for inclusión in clinical triáis and analysis of outcomes data in clinical studies. For clinicians and scientists engaged in research, it provides consistent nomenclature, which is essential for the study of cáncer from biology to clinical presentation to management.
Refining the standards by which to provide the best possible staging system is a neverending process. Toward this end, the American Joint Committee on Cáncer (AJCC) has led these efforts in the United States since 1959. A collaborative effort between the AJCC and the Union for International Cáncer Control (UICC) maintains the system that is used worldwide. This system classifies the extent of disease based mostly on anatomic information related to the extent of the primary tumor, the status of regional lymph nodes, and presence or absence of distant metastases (TNM classification). The basis of this classification was developed in the 1940s by Pierre Denoix of France and formalized by the UICC in the 1950s with the formation of the Committee on Clinical Stage Classification and Applied Statistics. The AJCC was founded in 1959 to complement this work.
The AJCC published its first cáncer staging manual in 1977. Since the 1980s, the work of the AJCC and UICC has been coordinated, resulting in concordant stage definitions and simultaneous publieation o f the AJCC Cáncer Staging Manual and the TNM Classification o f Malignant Tumours by the UICC. The revisión eyele has been 6 to 8 years, a time frame that provides for accommodation of advances in cáncer care while allowing cáncer registry systems to maintain stable operations. This new edition of the AJCC Cáncer Staging Manual being published in 2016 is effective for all cases diagnosed on or after January 1, 2017.
The ongoing work of the AJCC is made possible by the dedicated, continuous volunteer effort of hundreds, and perhaps thousands, of committed health professionals including physicians, population scientists, statisticians, cáncer registrars, supporting staff, and others. When the staging manual is being updated, volunteers, representing all relevant disciplines, are organized into expert panels chaired by leading clinicians. These panels make recommendations for changes in the staging system based on available evidence supplemented with expert consensus (see Chapter 2, Organization of the AJCC Cáncer Staging Manual). Over the years, as a result of these efforts, the TNM staging system has become the global standard for gathering, communicating, and exchanging cáncer information worldwide and is widely used by clinicians, the surveillance community, registrars, researchers, medical industries, patient advocates, and patients.
The process for review and revisión of the staging system has become increasingly rigorous with each new edition of the AJCC Cáncer Staging Manual. For each subsequent edition, a development team or “expert panel” is appointed for each disease site staging system or chapter. The expert panel includes experts from all relevant medical disciplines (surgical, medical and radiation oncology, pathology, radiology, and others; plus cáncer registrars, population scientists, statisticians, and other professionals). The AJCC expert panels are international in scope, and each panel consists of at least one individual representing the UICC. The expert panel revisits, restructures. validates. and researches data of the current system used in clinical practice. Based on this work. the expert panel makes appropriate revisions to the staging system, which are reflected in this publieation. The AJCC, for the first time, also empaneled seven AJCC cores with múltiple team members in each core, with defined functions and expertise. These cores, serving across all 18 disease site expert panels, include the Precisión Medicine Core, Evidence Based Medicine and Statistics Core. Content Harmonization Core, Data Collection Core, Professional Organization and Corporate Relationship Core, and Administrative Core. For this new edition, the editorial board worked to increase the level of documentation explaining the reasons for changes and the level of evidence supporting each change. The Evidence Based Medicine and Statistics Core established a system for quantifying the level of evidence supporting each major staging recommendation (see Chapter 2). The level of evidence supporting the staging systems and their ongoing refinement during the publication of the next edition varies among disease sites.
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