Global Consultation on Cancer Staging: promoting consistent understanding and use

• Published in: Nature reviews. Clinical oncology 2019-12, Vol.16 (12), p.763-771
• Main Authors: Brierley, James, O’Sullivan, Brian, Asamura, Hisao, Byrd, David, Huang, Shao Hui, Lee, Anne, Piñeros, Marion, Mason, Malcolm, Moraes, Fabio Y., Rösler, Wiebke, Rous, Brian, Torode, Julie, van Krieken, J. Han, Gospodarowicz, Mary
• Format: Article
• Language: English
• Subjects: 631/67/2322; 692/4028/67/1857; 692/4028/67/70; 692/700/139/1677; 692/700/478/174; Cancer; Care and treatment; Centers for Disease Control and Prevention, U.S. - standards; Classification; Clinical trials; Comprehension; Consensus; Consensus Statement; Global Health - standards; Humans; International organizations; Internationality; Literature reviews; Medical colleges; Medical Oncology - methods; Medical Oncology - organization & administration; Medical Oncology - standards; Medical prognosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Metastases; Metastasis; National Cancer Institute (U.S.) - standards; Neoplasm Staging - methods; Neoplasm Staging - standards; Neoplasms - diagnosis; Neoplasms - pathology; Oncology; Practice Patterns, Physicians' - standards; Prognosis; Terminology; Terminology as Topic; Tumor staging; Tumors; United States
• ISSN: 1759-4774; 1759-4782
• DOI: 10.1038/s41571-019-0253-x

Disease burden is the most important determinant of survival in patients with cancer. This domain, reflected by the cancer stage and codified using the tumour-node-metastasis (TNM) classification, is a fundamental determinant of prognosis. Accurate and consistent tumour classification is required for the development and use of treatment guidelines and to enable clinical research (including clinical trials), cancer surveillance and control. Furthermore, knowledge of the extent and stage of disease is frequently important in the context of translational studies. Attempts to include additional prognostic factors in staging classifications, in order to facilitate a more accurate determination of prognosis, are often made with a lack of knowledge and understanding and are one of the main causes of the inconsistent use of terms and definitions. This effect has resulted in uncertainty and confusion, thus limiting the utility of the TNM classification. In this Position paper, we provide a consensus on the optimal use and terminology for cancer staging that emerged from a consultation process involving representatives of several major international organizations involved in cancer classification. The consultation involved several steps: a focused literature review; a stakeholder survey; and a consultation meeting. This aim of this Position paper is to provide a consensus that should guide the use of staging terminology and secure the classification of anatomical disease extent as a distinct aspect of cancer classification. Attempts to incorporate additional criteria into the traditional tumour-node-metastasis staging classification have often resulted in inaccuracy and confusion in the use of terminology. In this Position paper, the authors provide guidance on the consistent use of the terminology relating to cancer staging.