Acute care of the cancer patient by Andrew D Shaw; et al

By Andrew D Shaw; et al

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11. Malkovska V, Sondel PM, Malkovsky. Tumor immunotherapy. Curr Opin Immunol 1989; 1:883–890. 12. Paget S. The distribution of secondary growths in cancer of the breast. Lancet 1889; 1:571–573. Killion and Fidler 13. Fidler IJ. A. Clowes memorial award lecture. Cancer Res 1990; 50:6130–6138. 14. Fidler IJ. Experimental orthotopic models of organspecific metastasis by human neoplasms. Adv Mol Cell Biol 1994; 9:191–215. 15. Price JE. Host–tumor interaction in progression of breast cancer metastasis.

The sentinel lymph III. CHANGES IN THE TNM-STAGING SYSTEM A. The Importance of Stability The TNM-staging system is not a static set of rules. Since its inception, it has evolved because of advances in detection, diagnosis, and treatment for every tumor site. Significant advances in clinical imaging have enabled physicians to use these noninvasive technologies to more accurately determine tumor size and nodal involvement. Improved survival as the result of developments in systemic treatment has resulted in alterations to both clinical and pathologic staging in some cases.

By ensuring this conformity, a uniform ‘‘language’’ is maintained for the exchange of clinical information among national and international treatment centers. Subsequent revisions of the TNMstaging system have been driven by significant advances in diagnosis and treatment, with the underlying goals of improving the assessment of prognosis and the ability to make appropriate treatment decisions. The latest revision of the TNM-staging system was published in 2002 (4,5) and officially adopted for use in tumor registries in January 2003.

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