China
Africa
Explore chapters and articles related to this topic
Malignant Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Mark Biro, Vesna Petronic-Rosic
Melanoma staging is determined according to the American Joint Committee on Cancer (AJCC) staging system. The AJCC staging system uses the TNM scale, where T corresponds to tumor thickness, also known as Breslow’s depth, N corresponds to nodal involvement, and M corresponds to sites of metastatic disease (Tables 21.7 and 21.8). Breslow’s depth is the most important staging characteristic and is measured from the granular layer to the deepest part of the melanoma. Presence of tumor ulceration increases the grade of the tumor. Depending on the stage of melanoma at the time of diagnosis, patients may require sentinel lymph node biopsy. If further metastatic evaluation is warranted, computer-assisted tomography (CAT) scan with contrast of the chest, abdomen, and pelvis or total body positron emission tomography may be completed. If there are findings suggestive of brain involvement, a brain MRI is recommended.
Multiparameter Gene Expression Assays and Breast Cancer Management
Published in Sherry X. Yang, Janet E. Dancey, Handbook of Therapeutic Biomarkers in Cancer, 2021
Della Makower, Joseph A. Sparano
The 8th edition of the American Joint Committee on Cancer (AJCC) Staging System, which took effect January 2018, incorporated prognostic and predictive biomarkers into the staging classifications. Under AJCC 8, breast cancers are assigned both an anatomic stage (clinical and pathologic) and a prognostic stage group. Prognostic stage incorporates anatomic stage, plus tumor grade, hormone receptor status, and HER2 status. Thus, tumors bearing markers predictive of good prognosis with current treatment are effectively down-staged, while those with poorer prognostic markers are upstaged. In addition, the AJCC Breast Cancer Expert Panel also evaluated incorporation of multiparameter gene expression panels into staging classification. They determined that the evidence for the excellent prognosis of tumors with an Oncotype DX low-risk RS was strong enough that any ER+ HER2-negative node-negative tumor under 5 cm with RS < 11 should be downstaged to a Pathologic Prognostic Stage group of IA. The panel determined that, at this time, only the Oncotype DX assay had generated robust enough data to alter tumor stage. However, they recommended that results of other gene expression assays, when available, should be collected by data registries, and left open the possibility of future modification of the staging system if more data becomes available [5].
Primary bone tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Jennifer N Murphy, Steven L J James, Murali Sundaram, A Mark Davies
Two staging systems are in current use: the Musculoskeletal Tumor Society (MSTS) system (Table 22.4) and the American Joint Committee on Cancer (AJCC) system (Table 22.5). The staging system adopted by the MSTS for staging of bone tumours built on the work of Enneking (67). This stages malignant lesions according to the local extent (T), the grade (G), and the presence or absence of regional or distant metastases (M). In this system, neoplasms are divided into two grades: low (G1) and high (G2). The anatomic extent (T) is divided according to whether the lesion is intracompartmental (A) or extracompartmental (B). The presence or absence of metastasis (M) is the final component of this staging system. The system adopted by the AJCC is similar to that devised by Enneking; however, there have been a number of modifications. These include the replacement of intraosseous or extraosseous extent of tumour with tumour size, which is thought to be of more prognostic importance, location of metastases and whether they involve lung only or involve other locations including bone and skip metastases in the same bone. In the recently published, updated AJCC staging system, tumours with skip metastases are staged as stage IB or III based on grade (68).
Surgical Research Progress of Sentinel Lymph Node Biopsy in Melanoma
Published in Journal of Investigative Surgery, 2023
Pathological information pertaining to regional lymph nodes also constitutes a critical basis for tumor staging. In the eighth edition of the American Joint Committee on Cancer (AJCC) staging system, the N staging is further refined to encompass both the number and extent of lymph nodes affected within the tumor area, as well as the extent of metastasis beyond the nodal region. The presence of microsatellites, satellites, or in-transit metastases is classified as N1c, N2c, or N3c, respectively, based on the cumulative count of regional lymph nodes affected. Microsatellite metastases are defined as any microscopic lesions adjacent to or deep but noncontiguous with the primary tumor. Satellite metastases, on the other hand, refer to cutaneous or subcutaneous metastases occurring within 2 cm of the primary lesion but not directly connected to it. In-transit metastases are generally characterized as those located more than 2 cm away from the primary lesion, within the region spanning between the primary lesion and the regional lymph node basin [41].
Identification and validation of a novel prognostic circadian rhythm-related gene signature for stomach adenocarcinoma
Published in Chronobiology International, 2023
Lei Qian, Xiaochen Ding, Xiaoyan Fan, Shisen Li, Yihuan Qiao, Xiaoqun Zhang, Jipeng Li
Since the circadian rhythm-associated gene signature demonstrated robust predictive ability, we hypothesized that it could potentially be used as an independent prognosis indicator. Based on the TCGA clinical data of patients with STAD, we analyzed sex data, the Lauren classification, the American Joint Committee on Cancer (AJCC) staging system, and the circadian rhythm-associated gene signature using multifactorial Cox regression analysis. According to the Lauren classification system, gastric adenocarcinomas can be divided into diffuse, intestinal, and mixed type (Lauren 1965). The AJCC staging system, also called TNM classification, is used to characterize the burden of cancer tissue in the body based on the Tumor Node and Metastasis (TNM) profile, in which T describes the tumor size and any spreading into nearby tissues, N describes whether the cancer has spread to nearby lymph nodes, and M describes whether the cancer has spread to other parts of the body (metastasis). Multivariate Cox regression analysis showed that age, sex, M, and the circadian rhythm-associated gene signature were significant independent prognosis indicators (Figure 3A). Subsequently, we created a nomogram comprising these factors (Figure 3B) aiming to precisely forecast patient survival risk for precision medicine.
A Nutrition and Inflammation-Related Nomogram to Predict Overall Survival in Surgically Resected Esophageal Squamous Cell Carcinoma (ESCC) Patients
Published in Nutrition and Cancer, 2022
Juan Li, Xinyu Mei, Di Sun, Mingfa Guo, Mingran Xie, Xia Chen
Histologically, there are two predominant subtypes of primary esophageal cancer: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). It is well recognized that EAC is the major subtype in the high-income countries, whereas there is a higher incidence of ESCC in developing countries (7) such as South Africa and countries in Eastern to Central Asia, suggesting ethnicity, genetics, and lifestyle are important factors in the development of ESCC (8). In the clinic, the most common cancer-related prognosis assessment system is the American Joint Committee on Cancer (AJCC) staging system, which establishes tumor-node-metastasis (TNM) subclassification based on the depth of invasion of the primary tumor (T), lymph node involvement (N), and extent of metastatic disease (M) (9). However, the TNM classification only focuses on tumor-specific characteristics without considering other factors. Additionally, the ESCC patients diagnosed at the same TNM stage who received similar therapy usually presented distinct outcomes, suggesting that it is imperative to develop a new tool that can assist the eighth edition AJCC-TNM staging system to provide reliable and accurate prognosis in individual patients (9).