Staging of pediatric cancers: problems in the development of a national system

The majority of the common pediatric cancers are managed on clinical protocols and are treated in pediatric oncology centers. For this reason these neoplasms are being staged by a variety of protocols depending on the protocol study. Examples of the evaluation and currently used staging systems for Wilms' tumor, neuroblastoma, and rhabdomyosarcoma are presented. The goal is to develop a nationally accepted staging system for these common pediatric tumors that is broadly accepted for treatment planning, determining prognosis, and comparing institutional end results. It is obvious that, if a nationally accepted staging system is to evolve, the leadership of the existing national clinic research trials must be part of the process.