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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
790:
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
754:
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,
512:
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
46:
755:
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).
484:
717:
1046:
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
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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1050:
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happen not to be present in the slices of tissue viewed, incorrect staging and improper treatment can result.
192:
1583:
1464:
1428:
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For solid tumors, TNM is by far the most commonly used system, but it has been adapted for some conditions.
408:
75:
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689:
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.
1521:
1502:
879:"An Operative Staging System and a Megavoltage Radiotherapeutic Technic for Cerebellar Medulloblastomas"
400:
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
396:
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529:). More recently, colon cancer staging is indicated either by the original A-D stages or by TNM.
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791:(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 (
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621:, abnormal cells growing in their normal place ("in situ" from Latin for "in its place").
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488:
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244:
167:
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Systems of staging may differ between diseases or specific manifestations of a disease.
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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
1229:
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544:
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257:
200:
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 (
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483:: For most brain cancers, no staging systems are available and they are instead
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Pathologic stage adds additional information gained by examination of the tumor
205:
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New, highly sensitive methods of staging are in development. For example, the
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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
894:
1278:
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404:
233:
158:
363:. Statements consisting only of original research should be removed.
163:
1170:"Staging: Questions and Answers" at the National Cancer Institute
439:, which has the same definitions of individual categories as the
196:
3D medical illustration depicting the TNM stages in breast cancer
1242:
392:
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491:
are staged following a classification developed by Chang et al.
685:
328:
29:
877:
Chang, Chu H.; Housepian, Edgar M.; Herbert, Charles (1969).
308:
Pathologic staging, where a pathologist examines sections of
595:
427:
Staging systems are specific for each type of cancer (e.g.,
525:: originally consisted of four stages: A, B, C, and D (the
757:"Breast cancer. Clinical practice guidelines in oncology"
1116:. National Comprehensive Cancer Network. Archived from
352:
61:
148:
Determining the extent to which a cancer has developed
925:"Breast Cancer Treatment - National Cancer Institute"
856:. International Agency for Research on Cancer. 2021.
718:"Five Things Physicians and Patients Should Question"
761:
Journal of the
National Comprehensive Cancer Network
157:
is the process of determining the extent to which a
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27:Process of determining the extent of cancer spread
624:Stage 0 can also mean no remaining cancer after
1024:. Cancerhelp.org.uk. 2010-07-28. Archived from
999:. 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
191:
700:
725:Choosing Wisely: an initiative of the
136:
947:"FIGO staging of cervical carcinomas"
732:American Society of Clinical Oncology
714:American Society of Clinical Oncology
251:after it has been surgically removed.
7:
1091:. Chorus.rad.mcw.edu. Archived from
1022:"The stages of cancer of the larynx"
949:. Screening.iarc.fr. Archived from
571:: uses TNM along with a measure of
517:cervical intraepithelial neoplasia
166:, whether it has invaded adjacent
25:
974:. oncologychannel. Archived from
831:. oncologychannel. Archived from
333:
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1114:"NCCN Guidelines for Patients"
1072:Imaging in Lung Cancer Staging
854:Central Nervous System Tumours
565:: TNM almost universally used.
501:, staging is usually based on
62:add the appropriate references
1:
1512:Clonally transmissible cancer
1089:"malignant melanoma: staging"
1047:"How is liver cancer staged?"
829:"Hodgkin's Disease - Staging"
284:recommend against the use of
170:, how many regional (nearby)
509:Cervical and ovarian cancers
499:breast cancer classification
487:. Embryonal CNS tumors like
359:the claims made and adding
47:reliable medical references
1605:
1543:Index of oncology articles
805:10.1016/j.juro.2007.03.003
282:professional organizations
210:hematological malignancies
185:
997:"Stages of kidney cancer"
945:Eric Lucas (2006-01-31).
519:) grading system is used.
53:or relies too heavily on
972:"Colon Cancer - Staging"
927:. Cancer.gov. 2010-08-13
579:Non-melanoma skin cancer
1465:Prostate cancer staging
1429:Paraneoplastic syndrome
1147:American Cancer Society
1139:"Bladder Cancer Stages"
774:10.6004/jnccn.2009.0012
1503:Tumor suppressor genes
1470:Gleason grading system
1424:Precancerous condition
793:The Journal of Urology
690:Will Rogers phenomenon
628:in some cancers (e.g.
626:preoperative treatment
600:
592:Overall stage grouping
197:
1522:Carcinogenic bacteria
1262:Malignant progression
662:: cancers have often
599:
409:colorectal metaplasia
401:intestinal epithelium
195:
1589:Anatomical pathology
1475:Dukes classification
539:Cancer of the larynx
527:Dukes staging system
222:physical examination
1294:Sentinel lymph node
1342:Respiratory system
684:(e.g., the use of
601:
397:guanylyl cyclase c
344:possibly contains
198:
188:TNM staging system
182:TNM staging system
1571:
1570:
1558:Cancer and nausea
1437:
1436:
1274:Carcinoma in situ
895:10.1148/93.6.1351
654:Hodgkin's Disease
630:colorectal cancer
569:Testicular cancer
460:Ann Arbor staging
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388:
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346:original research
279:medical specialty
262:radiation therapy
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16:(Redirected from
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1049:. Archived from
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889:(6): 1351–1359.
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741:on July 31, 2012
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563:Prostate cancer
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43:This article
41:
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1442:
1205:Overview of
1150:. Retrieved
1142:
1133:
1122:. Retrieved
1118:the original
1108:
1097:. Retrieved
1093:the original
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1026:the original
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951:the original
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833:the original
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736:the original
724:
682:
673:
664:metastasized
659:
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545:Liver cancer
523:Colon cancer
481:Brain cancer
475:
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258:chemotherapy
254:
206:brain tumors
199:
176:metastasized
154:
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114:
104:
97:
90:
83:
71:
51:verification
44:
1553:Cancer pain
1493:Cancer cell
1238:Hyperplasia
1152:29 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
1578:Categories
1498:Carcinogen
1362:Urogenital
1303:Topography
1284:Metastasis
1248:Pseudocyst
1222:Conditions
1143:Cancer.org
1124:2015-11-01
1099:2010-10-14
1057:2013-06-02
1032:2010-10-14
1007:2010-10-14
982:2010-10-14
957:2010-10-14
931:2010-10-14
839:2010-10-14
745:August 14,
696:References
616:carcinoma
353:improve it
319:lymph node
304:Pathologic
294:bone scans
230:radiologic
87:newspapers
1517:Oncovirus
1507:oncogenes
1460:Ann Arbor
1403:Papilloma
1388:Carcinoma
1381:Histology
1325:laryngeal
1269:Dysplasia
1253:Hamartoma
1077:eMedicine
903:0033-8419
883:Radiology
750:, citing
650:Stage III
413:prognosis
395:for GCC (
357:verifying
286:PET scans
238:endoscopy
117:June 2015
1538:Research
1398:Blastoma
1215:oncology
813:17509297
783:19200416
668:terminal
660:Stage IV
644:Stage II
557:Melanoma
456:Lymphoma
417:proteins
290:CT scans
1548:History
1447:grading
1443:Staging
1408:Adenoma
1393:Sarcoma
911:4983156
638:Stage I
618:in situ
612:Stage 0
511:: the "
423:Systems
351:Please
218:surgery
145:Purpose
101:scholar
66:removed
1279:Cancer
1211:cancer
1207:tumors
909:
901:
860:
811:
781:
485:graded
405:RT-PCR
310:tissue
236:, and
234:biopsy
168:organs
159:cancer
103:
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89:
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1531:Misc.
1417:Other
1357:Blood
739:(PDF)
721:(PDF)
497:: In
472:Solid
450:Blood
292:, or
247:by a
164:tumor
108:JSTOR
94:books
1563:Diet
1352:Skin
1347:Bone
1315:oral
1243:Cyst
1213:and
1154:2017
907:PMID
899:ISSN
858:ISBN
809:PMID
779:PMID
747:2012
513:FIGO
441:AJCC
437:UICC
431:and
393:mRNA
314:cell
260:and
208:and
80:news
49:for
1455:TNM
1075:at
891:doi
801:doi
797:177
769:doi
692:).
686:MRI
503:TNM
355:by
202:TNM
178:).
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