Purpose and principles of cancer staging
What staging is for, how to read a TNM string with its prefixes and suffixes, anatomical versus prognostic stage groups, the TNM 9th edition changes, non-TNM systems (Lugano, FIGO, R2-ISS, BCLC), stage migration and the pitfalls of restaging.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Staging describes anatomical extent of disease at diagnosis. It predicts prognosis, selects treatment (curative or palliative intent, adjuvant therapy), allows trial eligibility, and lets cancer registries compare outcomes between places and over time.
- Most solid tumours use TNM, maintained jointly by the UICC and AJCC so the two stay congruent. The UICC 9th edition is published; the IASLC lung revision has been in use since January 2025 (see Lung cancer).
- Stage is fixed at diagnosis. Later findings are recorded with a prefix (yp, r), never by rewriting the original stage.
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Sources
- Brierley JD et al. The 9th Edition of the UICC TNM Classification of Malignant Tumours: updates and rationale for change. Int J Cancer 2026;159(7):1588-1601Union for International Cancer Control, 9th edition (review online June 2026)
- AJCC Cancer Staging Manual, 8th edition (Amin MB et al., eds), with AJCC Version 9 site protocolsAmerican Joint Committee on Cancer / American College of Surgeons, 8th edition 2017; Version 9 chapters released by site from 2021
- Optimal care pathways for people with cancerAU/NZCancer Council Australia and Cancer Australia, 2nd editions, 2021 onwards
- Structured pathology reporting of cancer protocolsAU/NZRoyal College of Pathologists of Australasia
- Cheson BD et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32:3059-68Journal of Clinical Oncology, 2014
- Silvestri GA et al. Methods for staging non-small cell lung cancer: ACCP evidence-based clinical practice guidelines. Chest 2013;143(5 Suppl):e211S-e250SAmerican College of Chest Physicians, 2013
- D'Agostino M et al. Second Revision of the International Staging System (R2-ISS) for overall survival in multiple myeloma. J Clin Oncol 2022;40:3406-18Journal of Clinical Oncology, 2022
- Last updated
- 14 November 2026
What changed
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