scholarly journals Practical Concerns Regarding the 7th Edition AJCC Staging Guidelines

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
D. Buethe ◽  
C. Warner ◽  
J. Miedler ◽  
C. J. Cockerell
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cancer Staging ◽  
Nonmelanoma Skin Cancer ◽  
Lymph Node Status ◽  
Comprehensive Treatment ◽  
T Stage ◽  
7Th Edition

The 7th edition of the AJCC Cancer Staging Manual represents a dramatic shift in the way that cutaneous squamous cell carcinoma (cSCC) is staged, in that it is first attempt to incorporate evidence-based medicine into the staging guidelines for cSCC. In our opinion, the changes made to the seventh edition represent a significant improvement over previous editions and will ultimately lead to improved patient stratification, more accurate prognostic data, and a better framework to guide clinical decision making. However, there are a number of issues within the latest guidelines that require clarification or are impractical for clinical practice. The purpose of this paper is to highlight the key changes to the 6th edition staging manual as they pertain to cSCC, to point out impractical component of the 7th edition and/or aspects that require further clarification, and to make recommendations that address any current shortcomings to improve subsequent editions. Specific focus will be given to the inclusion of separate guidelines for cSCC and Merkel cell carcinoma (MCC), the incorporation of high-risk factors as modifiers of T stage, the addition of new guidelines for advanced T stage, and the changes in stratification of lymph node status. This paper is modified from a more comprehensive treatment of the staging of nonmelanoma skin cancer by Warner and Cockerell entitled“The new 7th edition American joint committee on cancer staging of cutaneous nonmelanoma skin cancer: a critical review,”in the American Journal of Clinical Dermatology (paper accepted, pending publication).

scholarly journals Development of an immune-related gene pairs index for the prognosis analysis of metastatic melanoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rong-zhi Huang ◽  
Min Mao ◽  
Jie Zheng ◽  
Hai-qi Liang ◽  
Feng-ling Liu ◽  
...  
Keyword(s):  
Decision Making ◽  
Skin Cancer ◽  
Metastatic Melanoma ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Gene Set Enrichment Analysis ◽  
Comprehensive Treatment ◽  
Related Gene ◽  
Gene Pairs ◽  
Immune Related Gene

AbstractMelanoma is a skin cancer with great metastatic potential, which is responsible for the major deaths in skin cancer. Although the prognosis of melanoma patients has been improved with the comprehensive treatment, for patients with metastasis, the complexity and heterogeneity of diffuse diseases make prognosis prediction and systematic treatment difficult and ineffective. Therefore, we established a novel personalized immune-related gene pairs index (IRGPI) to predict the prognosis of patients with metastatic melanoma, which was conducive to provide new insights into clinical decision-making and prognostic monitoring for metastatic melanoma. Through complex analysis and filtering, we identified 24 immune-related gene pairs to build the model and obtained the optimal cut-off value from receiver operating characteristic curves, which divided the patients into high and low immune-risk groups. Meantime, the Kaplan–Meier analysis, Cox regression analysis and subgroup analysis showed that IRGPI had excellent prognostic value. Furthermore, IRGPI was shown that was closely associated with immune system in the subsequent tumor microenvironment analysis and gene set enrichment analysis. In addition, we broken through the data processing limitations of traditional researches in different platforms through the application of gene pairs, which would provide great credibility for our model. We believe that our research would provide a new perspective for clinical decision-making and prognostic monitoring in metastatic melanoma.

scholarly journals Structured Reporting of Rectal Cancer Staging and Restaging: A Consensus Proposal

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2135
Author(s):  
Vincenza Granata ◽  
Damiano Caruso ◽  
Roberto Grassi ◽  
Salvatore Cappabianca ◽  
Alfonso Reginelli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Correlation Coefficient ◽  
Clinical Decision Making ◽  
Intraclass Correlation ◽  
Clinical Decision ◽  
Cancer Staging ◽  
Structured Reporting ◽  
Quality Analysis ◽  
Promising Tool ◽  
Structured Reports

Background: Structured reporting (SR) in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. The aim of this study was to build MRI-based structured reports for rectal cancer (RC) staging and restaging in order to provide clinicians all critical tumor information. Materials and Methods: A panel of radiologist experts in abdominal imaging, called the members of the Italian Society of Medical and Interventional Radiology, was established. The modified Delphi process was used to build the SR and to assess the level of agreement in all sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess the internal consistency of each section and to measure the quality analysis according to the average inter-item correlation. The intraclass correlation coefficient (ICC) was also evaluated. Results: After the second Delphi round of the SR RC staging, the panelists’ single scores and sum of scores were 3.8 (range 2–4) and 169, and the SR RC restaging panelists’ single scores and sum of scores were 3.7 (range 2–4) and 148, respectively. The Cα correlation coefficient was 0.79 for SR staging and 0.81 for SR restaging. The ICCs for the SR RC staging and restaging were 0.78 (p < 0.01) and 0.82 (p < 0.01), respectively. The final SR version was built and included 53 items for RC staging and 50 items for RC restaging. Conclusions: The final version of the structured reports of MRI-based RC staging and restaging should be a helpful and promising tool for clinicians in managing cancer patients properly. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making.

scholarly journals A Re-assessment of the Safety and Efficacy of Interleukin-2 for the Treatment of Renal Cell Carcinoma

2009 ◽  
Vol 1 ◽  
pp. CMT.S2037 ◽  
Author(s):  
Anthony Jarkowski ◽  
Michael K.K. Wong
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clinical Decision Making ◽  
Interleukin 2 ◽  
Clinical Decision ◽  
High Dose ◽  
Perceived Morbidity

Interleukin-2 (IL-2) can provide long term durable remissions for patients with advanced or metastatic renal cell carcinoma. The perceived morbidity and the difficulties in delivering this treatment hampered its widespread use in these patients. This review aims to place IL-2 in the modern milieu by reviewing the pharmacology, efficacy and toxicity of this drug. These will be contrasted and compared with the new targeted-agents. The methodology of providing high dose IL-2 treatment, follow-up care and its impact on patient quality of life will be discussed. Importantly, the ability of these agents to provide durable, complete remissions for RCC patients will be placed in context. The goal is to provide the perspective and framework for the reader to balance the important attributes of each of these drugs during the clinical decision making process.

scholarly journals Basal Cell Carcinoma in a Child

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Samet Vasfi Kuvat ◽  
Zuhal Gücin ◽  
Barış Keklik ◽  
Gülzade Özyalvaçlı ◽  
Karaca Başaran
Keyword(s):  
Skin Cancer ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Safety Margin ◽  
Nonmelanoma Skin Cancer ◽  
Pathologic Examination ◽  
Pigmented Lesion

Basal cell carcinoma is the most commonly seen nonmelanoma skin cancer which is rarely encountered in the childhood period. An 11-year old child was admitted to our clinic due to an erythematous and a slightly pigmented lesion with a3×4 cm diameter on his posterior scalp. Macroscopically, the lesion was excised with a 10 mm safety margin. Pathologic examination revealed a basal cell carcinoma. No symptoms or signs of a syndrome were observed both in the patient and his family.

scholarly journals Improvements in the Staging of Cutaneous Squamous-Cell Carcinoma in the 7th Edition of the AJCC Cancer Staging Manual

2010 ◽  
Vol 17 (8) ◽  
pp. 1979-1980 ◽  
Author(s):  
Thomas Lardaro ◽  
Sofia M. Shea ◽  
William Sharfman ◽  
Nanette Liégeois ◽  
Arthur J. Sober
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cancer Staging ◽  
Cutaneous Squamous Cell Carcinoma ◽  
7Th Edition

scholarly journals A Hospital-Wide Intervention to Improve Compliance With TNM Cancer Staging Documentation

2021 ◽  
pp. 1-10
Author(s):  
Jason H. Lee ◽  
Tariq Mohamed ◽  
Celia Ramsey ◽  
Jihoon Kim ◽  
Shelly Kane ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Quality Improvement ◽  
Clinical Decision Making ◽  
Compliance Rate ◽  
Clinical Decision ◽  
Cancer Staging ◽  
Marrow Transplant ◽  
Improvement Project ◽  
Logistic Regression Models ◽  
Oncologic Patients

Background: Accurate oncologic staging meeting clinical practice guidelines is essential for guideline adherence, quality assessment, and survival outcomes. However, timely and uniform documentation in the electronic health record (EHR) at the time of diagnosis is a challenge for providers. This quality improvement project aimed to increase provider compliance of timely clinical TNM (cTNM) or pathologic TNM (pTNM) staging for newly diagnosed oncologic patients. Methods: Providers in the following site-specific oncologic teams were included: head and neck, skin, breast, genitourinary, gastrointestinal, lung and thoracic, gynecologic, colorectal, and bone marrow transplant. Interventions to facilitate timely cTNM and pTNM staging included standardized EHR-based workflows, learning modules, stakeholder meetings, and individualized provider training sessions. For most teams, staging was considered compliant if it was completed in the EHR within the first 7 days of the calendar month after the date of the patient visit. Factors associated with staging compliance were analyzed using logistic regression models. Results: From January 1, 2014, to December 31, 2018, 7,787 preintervention and 5,152 postintervention new patient visits occurred. During the preintervention period, staging was compliant in 5.6% of patients compared with 67.4% of patients after intervention (P<.001). In the final month of the postintervention period, the overall staging compliance rate was 78.1%. At most recent tracking, staging compliance was 95%, 97%, and 93% in December 2019, January 2020, and February 2020, respectively. Logistic regression found that increasing years of provider experience was associated with decreased staging compliance. Conclusions: High rates of staging compliance in complex multidisciplinary academic oncologic practice models can be achieved via comprehensive quality improvement and structured initiatives. This approach serves as a model for improving oncologic documentation systems to facilitate clinical decision-making and multidisciplinary coordination of care.

Sign in / Sign up

Export Citation Format

Share Document