Common Concerns for Staging

• The stage of a cancer is sometimes confused with the grade of a tumor by new registrars.
  1. Terms such as well differentiated and undifferentiated are tumor grades.
• The rules for each staging scheme must be reviewed for each site and histology.
  1. AJCC sand Summary Stage list the sites and histologies applicable for each chapter.
• The term microinvasion implies invasion through the basement membrane (an anatomic landmark), indicating that the stage is invasive instead of in-situ.
• Some cases of cancer are difficult to stage appropriately. Problem situations include the following
  1. Diagnostic tests done on an outpatient basis with results not documented in the hospital health information record
  2. Tests and biopsies done in a physician's office and sent to freestanding laboratories for assessment
  3. Conflicting information about the exact location, size, and involvement of the cancer

There are many resources available for staging cancers. The Cancer Registry should have adequate access to appropriate references.

Manuals for the most commonly used staging systems or data collection systems provide comprehensive guidelines. These should be routinely reviewed at the time of abstracting to verify the staging classification and include

• AJCC Manual
• Summary Stage Manual
• Extent of Disease Manual

The patient's treatment is based on the extent of the cancer. The prognosis of the cancer can be estimated by the stage and other factors such as

• Age
• Aggressiveness of cancer
• Presence or absence of other medical conditions
• In certain stages of cancer, quality of life issues may influence treatment decisions.
• The stage of cancer is used in research studies and in the analysis of cancers

Updated: March 4, 2024