Report of the Committee on Hodgkin's Disease Staging Classification.
Report of the Committee on Hodgkin's Disease Staging Classification.
复制标题
DOI：
--
复制
发表时间：
1971-11
期刊：
影响因子：
11.2
通讯作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana
中科院分区：
文献类型：
--
作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana
自1965年Rye分期法产生以来，两个对分期有重大影响的重要观察结果的意义已得到重视。第一，淋巴外疾病，如果局限性和相关的邻近淋巴结疾病，不会对患者的生存产生不利影响。局限性淋巴外疾病患者与同期无淋巴外扩散的可比患者一样好。其次，剖腹术与脾切除术已被引入作为一种方法，以获得更多的信息，疾病的程度在腹部地区。因此，有必要重新考虑黑麦分类，并推荐一个修改后的方案。舞台有两个目标。一是促进沟通和信息交流。这样做只能以损失一些信息为代价，因为必须将大量数据浓缩在一个数字中。此外，相互比较要求每个中心进行的所有分期程序应尽可能相似，以避免分期和治疗结果解释的偏倚。第二个目的是提供预后指导，并协助治疗决策。当为每位患者收集最大量的信息时，后一个目标才能最好地实现。已经认识到，单一分期程序无法实现这两个目的。例如，很明显，剖腹手术和脾切除术提供了很多信息，但这些手术还不能推荐给每个患者。根据剖腹探查时获得的脾和淋巴结的组织病理学检查所获得的信息进行的分期分类不能与未经如此大力探查的另一种分期分类进行比较。因此，除非考虑到这些因素，否则治疗结果的相互比较几乎是不可能的，或者许多有价值的信息被排除在分期方法之外。因此，提出了两个分类系统。临床分期（CS）。虽然被认为是不完整的，但很容易执行，并且应该可以从一个中心复制到另一个中心。第二种称为病理分期（PS），它考虑了从有力的分期程序中获得的所有病理外数据，具有更高的精确度，但其应用局限于相对较少的中心。
Since the Rye classification for staging was produced in 1965, the significance of 2 important observations with major impact on staging has been appreciated. First, extralymphatic disease, if localized and related to adjacent lymph node disease, does not adversely affect the survival of patients. Patients with localized extralymphatic disease do as well as comparable patients of the same stage without extralymphatic spread. Secondly, laparotomy with splenectomy has been introduced as a method of obtaining more information on disease extent in the abdominal region. Thus, it has become necessary to reconsider the Rye classification and to recommend a modified scheme. Staging has 2 aims. The first is to facilitate communication and exchange information. This can be done only at the expense of a loss of some information, as it is necessary to condense in one number a considerable amount of data. Furthermore, intercomparison demands that all the staging procedures performed should be as similar as possible in each center to avoid bias in staging and interpretation of the therapeutic results. The second aim is to provide guidance of prognosis and to assist in therapeutic decisions. This latter aim is best achieved when the greatest amount of information is collected for each patient. It has been recognized that a single staging procedure cannot achieve these 2 purposes. For instance, it is obvious that laparotomy and splenectomy provide much information, but these procedures cannot yet be recommended for every patient. A staging classification based on information obtained by histopathological examination of the spleen and lymph nodes obtained at laparotomy cannot be compared with another done without such vigorous exploration. As a result, unless these factors are taken into account, either intercomparisons of therapeutic results become virtually impossible or much valuable information is excluded from the staging method. Therefore, 2 systems of classifications are presented. Clinical staging (CS). while recognized as incomplete, is easily performed and should be reproducible from one center to another. The second, called pathological staging (PS), takes into account all the extrapathological data obtained from vigorous staging procedures and has a higher degree of precision but is restricted in its application to relatively few centers.