To further enhance the value of clinical staging, the AJCC introduced the addition of pretreatment serum PSA and tumor grade to TNM classification in the seventh edition of the manual to create prognostic stage groups. As a result, many patients with newly diagnosed prostate cancer present with nonpalpable disease and are classified in the cT1c-category. Prostate cancer screening with serum levels of PSA, a protein produced by cells of the prostate gland, yields the majority of patients who are diagnosed annually, as the majority present with nonpalpable disease. As a consequence, the initial clinical assessment of the primary tumor has been based on digital rectal examination (DRE) findings and histologic confirmation of prostate cancer. 1 The vast majority of prostate cancer, approximately 95%, presents clinically localized to the prostate without definite evidence of metastasis (ie, cN0M0).
The TNM staging, used in combination with tumor grade and prostate-specific antigen (PSA), is regarded as a well accepted practice standard for prostate cancer and is used as the basis for guiding treatment decision making.Īccording to the American Cancer Society, approximately 161,360 new cases of prostate cancer will be diagnosed, and 26,730 men will die of this disease during 2017. The AJCC methodology uses the T (tumor extent), N (lymph node invasion), and M (presence or absence of metastasis) classifications to group patients. Staging is important to: 1) categorize the severity of disease, 2) estimate prognosis, 3) recommend treatment, and 4) aid health care providers and researchers in exchanging information about patients. The AJCC published the first edition of the Cancer Staging Manual in 1977.
DRIVE RIGHT ANSWERS EIGHTH EDITION UPDATE
The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the eighth edition in 2018. All newly diagnosed cases through Decemshould be staged with the seventh edition. To ensure that the cancer care community has the necessary infrastructure in place for documenting eighth edition stage, the AJCC Executive Committee, in dialogue with the National Cancer Institute Surveillance, Epidemiology, and End Results program the Centers for Disease Control and Prevention the College of American Pathologists the National Comprehensive Cancer Network the National Cancer Data Base and the Commission on Cancer, made the decision to delay implementation of the eighth edition cancer staging system to January 1, 2018.Ĭlinicians will continue to use the latest information for patient care, including scientific content of the eighth edition manual. The coordination of the implementation for a new staging system is critically important to ensure that all partners in patient care and cancer data collection are working in synchrony. The American Joint Committee on Cancer (AJCC) has been working closely with all of its member organizations throughout the development of the recently published eighth edition Cancer Staging Manual.
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