Staging (oncology)

As staging or "Staging" (English) is referred to in the oncology the part of the diagnosis , the degree of detection of the propagation of a malignant Tumores used. It becomes the basis for deciding which therapy is advised to the patient.

Methods

All diagnostic options are used to determine the stage of cancer. Even a physical examination with simple aids provides initial indications, for example of the involvement of superficial lymph nodes . Imaging methods are particularly important in staging . Often biopsies are taken from the primary focus, from metastases or from suspicious lymph nodes. In some situations the spread of the tumor can only be clarified with a diagnostic ( exploratory ) operation . If tissue is obtained, the histology and cytology can also be used to infer the biological properties of the tumor ( grading ; shown in the pathological findings as G1, G2, G3, possibly also G4).

Systematics

Various systems have been developed for staging. Solid tumors are usually classified according to the TNM system . T stands for tumor (its local spread), N for node (lymph node infestation) and M for metastases (daughter tumors outside the primarily affected organ).

Other well-known classifications used in cancer registries include:

• Ann Arbor classification ( lymphomas )
• Staging according to Rai and Binet ( chronic lymphocytic leukemia )
• CML phases ( chronic myeloid leukemia )
• Staging according to Durie and Salmon ( multiple myeloma )
• FAB classification (classification of the French-American-British Cooperative Group) ( acute myeloid leukemia )
• Gleason score ( prostate cancer )

Stage as a basis for decision-making

Various therapeutic approaches are available for the treatment of cancer. Most treatment methods are highly effective, but also fraught with significant side effects and dangers. Determining the staging helps to make the best choice in each situation. In stages I and II, this is often a surgical procedure with resection of the tumor or removal of the affected organ, occasionally supplemented by local radiation therapy . If the disease spreads further, surgery is often of little use. Instead, systemic therapy (radiation or chemotherapy ) can be more promising.

If, due to the staging, it is clear that cancer cannot be treated curatively (with the prospect of a cure), the oncologist takes a more cautious approach and offers palliative therapy , i.e. one that aims to improve the quality of life instead of extending life.

The existing staging systems do not claim to fully describe the spread of a disease. Rather, they enable a rough classification, an assessment of the prognosis and a systematic recording of the course of a disease and the success or failure of a therapy. The latter aspect is particularly important when it comes to gathering experience at different treatment centers ( cancer registries ) and making it usable for an individual patient.

Web links

National Cancer Institute: Staging: Questions and Answers

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !