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Breast cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Alexandra Athanasiou
The tumour nodes metastases (TNM) system is used for breast cancer staging. In prior editions staging was anatomically based, but the eighth edition, effective as of January 2018, incorporates receptor status and gene expression prognostic panels, if available (77). It recognizes that biomarkers and assays such as Oncotype DX modify prognosis and hence pure anatomical stage grouping (Tables 8.4 and 8.5, Figure 8.5). For example, patients with TNBC have survival comparable to that of patients with ER+ disease one stage higher (Table 8.6).
Gastrointestinal Cancer and Complementary Therapies
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Traditional treatment options for patients vary depending on the type of cancer and staging based on the American Joint Committee for Cancer staging (Greene et al., 2006) through the determination of the size of the primary tumor, regional lymph node involvement, and the presence of metastasis. Treatment options include chemotherapy, radiation, combination chemotherapy, and radiation and surgery. Each treatment modality poses risks for developing nutrition impact symptoms, ultimately affecting nutrition status. Stent placement, laser therapy, and electrocoagulation are also available; however, these therapies tend to be used more for palliation in esophageal cancer (Mawhinney and Glasgow, 2012).
Breast cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2014
Thomas Rackley, Sharath Gangadhara, Elin Evans, Simon Waters, Peter Barrett-Lee
Clinical and pathologic staging is routinely used to obtain baseline prognostic information, to compare results from clinical trials and across institutions, and for choosing optimum local and systemic treatment options. The tumour node metastasis (TNM) staging system for breast cancer is commonly followed but periodic revisions of TNM staging are essential due to advances in imaging techniques and treatments that impact survival. In 2010, important changes and additions to the 2003 TNM staging system were implemented in the AJCC revised Cancer Staging Manual (seventh edition) (Table 6.1).12
Influence of various assumptions for the individual TNM components on the TNM stage using Nordic cancer registry data
Published in Acta Oncologica, 2023
Gerda Engholm, Frida E. Lundberg, Simon M. Kønig, Elínborg Ólafsdóttir, Tom B. Johannesen, David Pettersson, Lina S. Mørch, Anna L. V. Johansson, Søren Friis
Cancer staging using tumor size (T), nodal spread (N) and distant metastasis (M), known as the TNM stage classification, is an important tool in the management of cancer patients and one of the most important predictors for cancer survival [1,2]. Moreover, information on TNM-staging is a valuable tool in empirical research, e.g., epidemiological cancer surveillance studies based on cancer registry data [1]. The TNM stage is cancer site-specific and derived from three components: T (main values 1–4), describing the extent of the primary tumor, N (0–3) denoting the absence or presence and extent of regional lymph node metastases, and M (0,1) denoting absence or presence of distant metastases. The TNM stage can be assessed and registered as a clinical classification, cTNM, or a postsurgical histopathological classification, pTNM. Manuals for TNM-staging are updated regularly and provide specifics at the cancer site-specific level on how each component, i.e., T, N, and M, should be assessed and the final TNM stage determined [1].
A Digital Population Tracking System Helps Improve Colorectal Cancer Survivorship Services
Published in Oncology Issues, 2021
Raymond Liu, Aileen Demucha Flores, Jeffrey Lee, Devon Check, Tilak Sundaresan, Yan Li, I-Yeh Gong, Larissa Nekhlyudov, Ronald M. Kline, Leslie Manace
As the first step for creating a population-level tracking system for survivorship care, we developed a methodology to identify Stage I through Stage III survivors of colon cancer, aged 18 to 85, through our EHR. Real-time, automated identification of these patients required two critical data elements: 1) cancer staging information and 2) the date active treatment ends. To achieve EHR integration, we asked our providers to input staging data into the colon cancer specific section of the EHR “problem list” (Figure 1, page 21). Next, we created a dedicated location in the problem list to document the end-of-treatment date (Figure 1). To improve staging compliance, over time we are incorporating a “hard stop” in the EHR that would prevent completion of charting if staging data has not been entered.
Survival following rectal cancer surgery: does the age matter?
Published in Acta Chirurgica Belgica, 2019
Yahya Al-Abed, Michael Parker, Tan Arulampalam, Matthew Tutton
At Colchester Hospital University an efficient enhanced recovery program is run with robust prospectively collected data on all patients undergoing colorectal cancer resections. Over a ten-year period from January 2005 to December 2014, a retrospective analysis of the prospectively collected data on all patients who underwent radical rectal cancer surgery was performed. Patients who had rectal cancer surgery were identified by those undergoing an anterior resection, low anterior resection, ultralow anterior resection and abdominoperineal resection. To avoid including sigmoid cancers, the data was correlated with the final histological diagnosis and exclusions applied accordingly. Data collected were patient demographics, clinical data, age, sex, neo-adjuvant cancer treatment, cancer Duke’s stage, Cancer TNM staging, stoma status, post-operative complications and mortality including long term survival follow-up. TNM Cancer staging was available for 335 out of the 374 patients and the remaining 39 patients were assigned to the category “None.” Duke’s cancer classification was available for 335 patients. Patients with missing values for other essential variables, such as histology results or survival indicators, were excluded from the study.