- Joined
- Dec 4, 2007
- Messages
- 63
- Reaction score
- 5
Does anyone know if the next in-service 3/2017 is using AJCC 8th staging?
Our H&N-pathologist gave us an update today after the tumor-board.
The H&N-TNM has sone ... interesting changes.
Different stages for N-disease based on clinical (cN) or pathology (pN) report?
N-stage in oropharynx cancer directly linked to p16-status?
Why keep it simple, if you can make it complicated...
Our H&N-pathologist gave us an update today after the tumor-board.
The H&N-TNM has sone ... interesting changes.
Different stages for N-disease based on clinical (cN) or pathology (pN) report?
N-stage in oropharynx cancer directly linked to p16-status?
Why keep it simple, if you can make it complicated...
Oh god. Not the cN vs pN crap like they did when they did it with breast cancer. What about patients who have definitive chemoRT without pathologic staging? At least in non-metastatic breast, there's a surgery happening at some point so there will always be some amount of pathologic staging (whether it's p or yp)
N-stage directly linked to p16? I imagine that p16 for HPV+ would be associated into the staging like how PSA factors in for prostate, or Grade for Esophageal SCC. Don't see why HPV+ should change the actual N staging of TNM.
I was expecting p16+ staging (basically knowing what combination of TNM translates into what stage) would be simpler given that so many subsets had survival on the order of a stage I or II even with massively locally advanced disease.
Now I'm much more curious.
I purchased the manual thinking I would need it for this year. For p16 (+) , there are indeed distinct clinical and pathologic N-stages as well as distinct clinical and pathologic overall stage grouping.
cN1: one or more ipsi node(s) </= 6 cm
cN2: contralateral or bilateral nodes </= 6 cm
cN3: node(s) > 6 cm
pN1: </= 4 nodes
pN2: > 4 nodes
There's also now slightly different clinical and pathologic N-staging for other H&N sites.
cN3b = clinical ENE
pN2a = single ipsi node with pathologic ENE and size </= 3 cm
pN3b = single ipsi node with pathologic ENE and size > 3 cm or multiple ipsi, contralateral, or bilateral nodes with pathologic ENE.
Is there any information as to whether we need to know AJCC 8th edition for the 2018 oral boards (not this year)?
<=4 nodes? Does it matter how many nodes were taken in all? Does it matter if they're unilateral or bilateral (in setting of B/L neck dissections)?
Clinical ENE? How do you define that? CT-based? Need an MRI to make that call? The FDG-avidity on PET/CT (exaggerating on this one)? There's going to be a number of patients that are cN1 vs cN3b based off a radiologist read about 'extranodal extension cannot be excluded'.
I'm OK with pathologic ENE being included in pathological staging given the decisions it makes for us regarding adding chemo to adjuvant RT.
Any chance you can go through all of the a's and b's of pathologic nodal staging? What's pN2b? what's pN1b? what's pN3a?
With the implementation being next month, curious if people are sucking it up and purchasing this piece of crap hardcover full of typos or waiting for the updated version? Anyone know when the updated is coming out? Or the paperback, smaller handbook?
Typos. Check the insane stage grouping table for breast cancer. Then try to stage a T3N0 tumor going through all grades and receptor statuses.