Application of Cancer Biology in Cancer Staging and Predicting Clinical Outcome

Abstract

The importance of staging cannot be overemphasized in the management of patients. A primary role for staging is to stratify patients into groups that are prognostically and therapeutically similar. Without having this framework it would be difficult to have any meaningful clinical trials. A second goal for staging is that it allows for comparison across large populations either within geopolitical borders or between disparate countries. Tumor-node-metastasis (TNM) elements and the combination of these elements (stage group) serve as one of the most important prognostic factors in making assumptions relative to the overall survival of the cancer patient. The strategy is to apply well-tested evidence-based methodology to each factor to assess the significance and statistical power prior to applying the specific factor to the TNM lexicon. The traditional prognostic parameters for human breast cancer have stood the test of time and currently include specific tumor factors of size, lymph node status, and grade of tumor. The role of axillary nodal and lymphovascular involvement cannot be overemphasized in the prognosis and staging of many solid tumors. Current strategies have included the number of tumor-containing nodes in the locoregional area as well as the volume of tumor contained in these nodal elements. The introduction of artificial intelligence and the unification of concepts within the structure of nomograms will no doubt help to refine the language of cancer and will give a greater acuity of information to physicians, patients, and their caregivers. PU - HUMANA PRESS INC PI - TOTOWA PA - 999 RIVERVIEW DR, STE 208, TOTOWA, NJ 07512-1165 USA