AJCC new staging game...

[Radonc90]

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[StIGMA]

pT??? and pN??? are still allowed though

 

[ramsesthenice]

pT??? and pN??? are still allowed though

The official designation is now pTwtf

 

[Mandelin Rain]

I feel like every member of the AJCC board deems it necessary to justify their position by making some annoying/confusing/esoteric change to the staging of cancer, often for no good reason.

 

[TheWallnerus]

pT

One day, I'm sure.

 

[ramsesthenice]

I feel like every member of the AJCC board deems it necessary to justify their position by making some annoying/confusing/esoteric change to the staging of cancer, often for no good reason.

You are sadly correct. This goes for all committee-based organizations (I’m looking at you NCCN). Beyond T, N, M classification, stage grouping has 2 purposes: prognostification and treatment grouping. Period. Quick, can anyone tell me the difference between a 2c or 3b gastric cancer? I bet I treat as many gastric cancers as almost any US rad onc and I couldn’t tell you the answer. I also bet you know how you would treat them and a good guesstimate of their expected survival without knowing the nitty gritty details. So why does the complex stage grouping even exist in this context?

 

[Neuronix]

AJCC Emoji edition

pT previously X
pT previously 0
pT previously 1
pT previously 2
pT previously 3
pT previously 4

 

[Mandelin Rain]

You are sadly correct. This goes for all committee-based organizations (I’m looking at you NCCN). Beyond T, N, M classification, stage grouping has 2 purposes: prognostification and treatment grouping. Period. Quick, can anyone tell me the difference between a 2c or 3b gastric cancer? I bet I treat as many gastric cancers as almost any US rad onc and I couldn’t tell you the answer. I also bet you know how you would treat them and a good guesstimate of their expected survival without knowing the nitty gritty details. So why does the complex stage grouping even exist in this context?

Esophageal staging can go straight to hell.

 

[medgator]

Esophageal staging can go straight to hell.

Has anyone figured out breast yet

 

[Mandelin Rain]

I can't imagine taking boards at this point. Not that memorizing staging was "easy" when I took it, but it didn't require a satellite GPS tracker.

 

[Ray D. Ayshun]

Esophageal staging can go straight to hell.

esophagus has always been cTsendtoradonc and cTdon'tsendtoradonc.

though that's more or less all cancer staging.

 

[Mandelin Rain]

esophagus has always been cTsendtoradonc and cTdon'tsendtoradonc.

though that's more or less all cancer staging.

For one poster in particular

Breast Cancer N staging:
N0, now NnoregionalXRT
N1-3, now NdefinitelyregionalXRT

 

[metallica81788]

AJCC Emoji edition

pT previously X
pT previously 0
pT previously 1
pT previously 2
pT previously 3
pT previously 4

That's more intuitive than teal, sky blue, and beige umber staging

 

[Palex80]

Has anyone figured out breast yet

Remmeber: Breast is the worst. Always.

You are sadly correct. This goes for all committee-based organizations (I’m looking at you NCCN). Beyond T, N, M classification, stage grouping has 2 purposes: prognostification and treatment grouping. Period. Quick, can anyone tell me the difference between a 2c or 3b gastric cancer? I bet I treat as many gastric cancers as almost any US rad onc and I couldn’t tell you the answer. I also bet you know how you would treat them and a good guesstimate of their expected survival without knowing the nitty gritty details. So why does the complex stage grouping even exist in this context?

 

[ramsesthenice]

Remmeber: Breast is the worst. Always.





View attachment 340575

Typically I only treat the people who start periop chemo and have poor/no pathological responses to FLOT or are unresectable/refuse surgery. For the former we (me and the 2 oncologists who specialize in gastric) just don’t see the point in continuing fairly toxic chemo if the tumor shows you it more or less doesn’t care. It’s not usually something we are planning from the start. are talking <10 people per year. A small fraction of our total gastric population.

And yes, breast is the worst. Period. Always.

Esophageal staging can go straight to hell.

Another case in point. T2+ or N+, preop CRT plus surgery if resectable. For the rare early stage tumors that are potentially managed by endoscopic therapy granularity could play a little bigger role but not much.

 

[RadOncDoc21]

Has anyone figured out breast yet

Breast is the worstest! I’ve said this for over 10 years now and it’s only getting worster(it’s worse then worst).