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The Tumor Microenvironment02:17

The Tumor Microenvironment

Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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Whither TNM?

Mithat Gönen1, Martin R Weiser

  • 1Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. gonenm@mskcc.org

Seminars in Oncology
|February 23, 2010
PubMed
Summary
This summary is machine-generated.

Cancer staging systems like tumor-node-metastasis (TNM) are adding more categories, but this complexity isn't improving accuracy. Future revisions should prioritize simplicity for better cancer prognostication.

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Area of Science:

  • Oncology
  • Medical Informatics
  • Biostatistics

Background:

  • Cancer staging is crucial for diagnosis, treatment, and prognosis.
  • Advances in molecular genetics, statistics, and computer science challenge traditional staging accuracy.
  • Staging systems, like TNM, are evolving by increasing stage groupings.

Purpose of the Study:

  • To examine the historical increase in cancer stage groupings.
  • To evaluate if recent increases in stage groups enhance usability or prognostic ability.
  • To advocate for parsimony in future staging system revisions.

Main Methods:

  • Historical analysis of cancer staging system revisions.
  • Evaluation of the impact of increased stage groupings on prognostic accuracy and ease of use.
  • Review of tumor-node-metastasis (TNM) classification changes.

Main Results:

  • Cancer staging systems have progressively increased their number of stage groupings over time.
  • Recent expansions in stage categories have not demonstrably improved prognostic ability.
  • Increased complexity has not led to enhanced ease of use for clinicians.

Conclusions:

  • The trend of increasing stage groups in cancer staging systems like TNM may not be beneficial.
  • Parsimony (simplicity) should be a guiding principle in future staging system updates.
  • Revisions should balance the incorporation of new data with the need for practical and accurate prognostication.