TNM staging for malignancies of the digestive tract: 2003 changes and beyond

In preparation for the 6th edition of the UICC and AJCC publications on TNM staging, all data regarding sites of the digestive system (gastrointestinal and hepatobiliary) were reviewed by expert site teams. Although the information for several sites (esophagus, small bowel, and anal canal) required no change from the 5th editions, significant changes were recommended for the pancreas, liver, extrahepatic biliary system, colon, and rectum. Minor but important changes were made regarding gastric and peri-ampullary malignancies. The changes were made based on new prognostic information and analysis of available data sets. The importance of large national registries, such as the National Cancer Data Base (NCDB; American College of Surgeons Commission on Cancer), is stressed.