The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging
The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging
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DOI：
10.3322/caac.21388
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发表时间：
2017-03-01
影响因子：
254.7
通讯作者：
Winchester, David P.
中科院分区：
文献类型：
--
作者：
Amin, Mahul B.;Greene, Frederick L.;Winchester, David P.
美国癌症联合委员会(AJCC)分期手册已成为癌症患者分类、定义预后和确定最佳治疗方法的基准。许多人认为，肿瘤、淋巴结、转移(TNM)系统的主要作用是一个标准化的分类系统，用于在人群水平上评估癌症的程度，包括最初出现的疾病程度和手术治疗后的情况，以及癌症治疗改进的总体影响。癌症生物学知识的快速发展，以及对预测癌症结果和更准确地治疗反应的生物因素的发现和验证，导致一些癌症专家质疑基于TNM的方法在个性化患者水平的临床护理中的有效性。在第八版AJCC癌症分期手册中，包括相关的、非解剖学(包括分子)因素的目标一直是首要的，尽管只有在有强有力的证据支持纳入时才会做出改变。编委会认为，这次迭代是一次积极的努力，旨在继续建立从基于人群的患者分类到更个性化的患者分类的重要桥梁，这一方法构成了精确分子肿瘤学时代癌症分期的概念框架和基础。AJCC通过每个新版本公布最佳分期实践，以努力为癌症护理人员提供与癌症作斗争的强大的、基于知识的资源。在这篇评论中，作者重点介绍了第八版的总体组织和结构变化以及新内容。希望这些信息将使读者更好地理解在即将出版的版本中提出的总体变化和令人兴奋的发展背后的基本原理。(C)2017年美国癌症协会。
The American Joint Committee on Cancer (AJCC) staging manual has become the benchmark for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. Many view the primary role of the tumor, lymph node, metastasis (TNM) system as that of a standardized classification system for evaluating cancer at a population level in terms of the extent of disease, both at initial presentation and after surgical treatment, and the overall impact of improvements in cancer treatment. The rapid evolution of knowledge in cancer biology and the discovery and validation of biologic factors that predict cancer outcome and response to treatment with better accuracy have led some cancer experts to question the utility of a TNM-based approach in clinical care at an individualized patient level. In the Eighth Edition of the AJCC Cancer Staging Manual, the goal of including relevant, nonanatomic (including molecular) factors has been foremost, although changes are made only when there is strong evidence for inclusion. The editorial board viewed this iteration as a proactive effort to continue to build the important bridge from a population-based to a more personalized approach to patient classification, one that forms the conceptual framework and foundation of cancer staging in the era of precision molecular oncology. The AJCC promulgates best staging practices through each new edition in an effort to provide cancer care providers with a powerful, knowledge-based resource for the battle against cancer. In this commentary, the authors highlight the overall organizational and structural changes as well as what's new in the Eighth Edition. It is hoped that this information will provide the reader with a better understanding of the rationale behind the aggregate proposed changes and the exciting developments in the upcoming edition. (C) 2017 American Cancer Society.