AJCC new staging game...
Started by Radonc90
The official designation is now pTwtf
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.
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pT🤔
One day, I'm sure.
One day, I'm sure.
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.
Has anyone figured out breast yet
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.
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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
That's more intuitive than teal, sky blue, and beige umber staging
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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.
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.
Breast is the worstest! I’ve said this for over 10 years now and it’s only getting worster(it’s worse then worst).
