ABSTRACT
The results of expressing patient outcome are compared using two staging systems: localized, regional, and distant (LRD) and the TNM of the American Joint Committee on Cancer (AJCC). Expressing patient outcome depends on the staging system used. There is overlap between the stage definitions of the LRD and the TNM. A single stage in the LRD may include more than one stage grouping of the TNM and vice versa. For most sites, "localized" provides lower survival rates than stage I of the TNM. The TNM provides more precise information about prognosis because its definitions reflect the latest survival information and diagnostic technology. Time trends can be measured only with the LRD because of its stability over the years. The precision of the TNM has been achieved at the expense of time trend analysis. The LRD is usually not an acceptable end point for the assessment of early cancer detection.
Subject(s)
Neoplasm Staging/methods , Neoplasms/pathology , Breast Neoplasms/classification , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Digestive System Neoplasms/classification , Digestive System Neoplasms/mortality , Digestive System Neoplasms/pathology , Female , Genital Neoplasms, Female/classification , Genital Neoplasms, Female/mortality , Genital Neoplasms, Female/pathology , Humans , Lung Neoplasms/classification , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Lymphatic Metastasis , Melanoma/classification , Melanoma/mortality , Melanoma/pathology , Neoplasm Staging/standards , Neoplasms/classification , Neoplasms/mortality , Prognosis , Skin Neoplasms/classification , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Time Factors , United StatesABSTRACT
A total of 24 cases of osteogenic sarcoma of the mandible have been reported to the SEER Program of the National Cancer Institute from 1973 to 1983. Out of 14 patients whose disease was staged as regional, only 9 were eligible for 5-year survival figures and only 2 are alive, for a 23 percent 5-year cure. For those patients staged as localized, only four of six eligible for 5-year cure survived, for a 66 percent 5-year survival. Considering all patients reported to SEER who were eligible for 5-year cure, the rate is 40 percent. We believe this reflects the practice of localized resection of these tumors. At Charity Hospital of Louisiana at New Orleans there have been 10 cases of osteogenic sarcoma of the mandible since 1948. There have been no 5-year survivors for those operated on by other services, usually by local resection. On the Tulane Plastic Surgery Service, a total of six cases of osteogenic sarcoma of the mandible were treated by radical surgery with 100 percent survival from 11 to 22 years.