What's new in TNM?

As other parameters of tumor classification, TNM as well can never be considered definitive because advances in diagnosis and treatment as well as in knowledge of prognostic factors require adaption of current classifications. On the other side, the need for stability in tumor classification is obvious for accumulation of data in an orderly way over reasonable periods of time. The last edition of TNM, i.e. the fourth edition has been published in 1987 and was the result of an international effort to unify the classifications of Union Internationale Contre le Cancer (UICC) and American Joint Commission on Cancer (AJCC). Since 1987 changes in the classification for corpus uteri and vulva have been made by the Fédération Internationale de Gynécologie et d'Obstetrique (FIGO). This made a revision of the TNM classification necessary to ensure the complete agreement of TNM and FIGO classifications. In the revision 1992 some further changes were added for improvement. A further publication, namely the TNM Supplement 1993, available from November 1993, contains explanatory notes to enable a uniform use of TNM, proposals for new classifications and optional proposals for testing new telescopic ramifications. The latter are a way to collect data for further improvement of TNM and will be the first step for the preparation of the 5th edition, which will not be published until the year 2000. The aim of this publication is to inform pathologists on the essential changes in TNM as far as pathological classification is involved.