Gospodarowicz Mary K, Miller Daniel, Groome Patti A, Greene Frederick L, Logan Pamela A, Sobin Leslie H
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Cancer. 2004 Jan 1;100(1):1-5. doi: 10.1002/cncr.11898.
The TNM classification is a worldwide benchmark for reporting the extent of malignant disease and is a major prognostic factor in predicting the outcome of patients with cancer. The objectives for cancer staging were defined by the International Union Against Cancer (UICC) TNM Committee almost 50 years ago and are still broadly applicable today. To keep pace with the modern demands of evidence-based practice, the UICC introduced a structured process for introducing changes to the TNM classification. The elements of the TNM process were determined to include the development of unambiguous criteria for the information and documentation required to consider changes in the classification, establishment of a well-defined process for the annual review of relevant literature, formation of site-specific expert panels, and the participation of experts from all over the world in the TNM review process. Communication between the oncology community and those involved in the TNM classification was established as being essential to the success of the process. The process, which was introduced in 2002, will be tested over the next 3-4 years and evaluated. In addition to the formal process, individual initiative, involvement by the national staging committees, and group consensus are required. Furthermore, increased involvement by the experts should improve the understanding and dissemination of the TNM classification.
TNM 分类是报告恶性疾病范围的全球基准，也是预测癌症患者预后的主要预后因素。癌症分期的目标大约在 50 年前由国际抗癌联盟（UICC）TNM 委员会确定，至今仍广泛适用。为了跟上循证医学实践的现代需求，UICC 引入了一个结构化流程来对 TNM 分类进行修订。TNM 流程的要素包括制定明确的标准，以确定考虑分类变更所需的信息和文件；建立明确的年度相关文献审查流程；组建特定部位的专家小组；以及让世界各地的专家参与 TNM 审查过程。肿瘤学界与参与 TNM 分类的人员之间的沟通被认为是该流程成功的关键。该流程于 2002 年推出，将在未来 3 - 4 年进行测试和评估。除了正式流程外，还需要个人的主动性、国家分期委员会的参与以及团体共识。此外，专家更多的参与应能增进对 TNM 分类的理解和传播。
