Introduction of 7th AJCC TNM Staging for Liver and Intrahepatic Bile Duct Malignancies

ABSTRACT

PURPOSE: Cancer staging is essential in clinical cancer practice in medical and surgical oncology. Staging based on the guidelines of the American Joint Committee on Cancer (AJCC) is the most popular and is widely used in clinical fields. Early this year, the 7th edition of the AJCC cancer staging manual was published. I have compared and described the changes in the new edition from the older version to facilitate staging in clinical settings, especially for liver and intrahepatic bile duct malignancies. METHODS: On the basis of the new 2010 edition of the 7th AJCC TNM cancer staging manual, I have compared hepatobiliary malignancy in Chapter 18, liver malignancy and intrahepatic bile duct malignancy in Chapter 19. RESULTS: One of the major changes in the 7th AJCC manual compared to the 6th AJCC staging manual published in 2002 is separation of the Liver and Intrahepatic bile duct cancer chapters. In the previous edition, intrahepatic bile duct cancer was included in the liver malignancy chapter. CONCLUSION: There are no universal and permanent staging systems for cancer. The staging systems are ever changing to adjust for changes in treatment and prognosis of malignancies. We need to collect data in order to modify the staging correctly in collaboration with multi-institutional efforts to reduce biases in staging liver and intrahepatic bile duct cancers.