[[Tumor]] [[Node]] [[Matastasis]] 3가지 기준을 종합하여 결정한다. T staging 암의 침윤 깊이 또는 암의 크기로 판정한다. [[Solid organ]]은 암의 크기로 판정하고 [[Hollow organ]] 은 암의 조직 침윤 깊이로 판정한다. N staging 림프절 전이로 판정한다. 전이된 주변 림프절 개수나, 중요한 림프절로의 전이된 경우 멀리 떨어진 림프절로의 전이는 원격전이로, N이 아닌 M staging에 반영한다. M staging 전이된 장기를 기준으로 판단한다. 타 장기, 원격 림프절(먼 림프절)로의 전이가 많이 된 경우 --- The TNM staging system is a globally recognized standard for classifying the anatomical extent of cancer spread[1]. Developed by Pierre Denoix between 1943 and 1952, it has become the most widely used cancer staging system by medical professionals worldwide[1][2]. ## Components of TNM Staging The TNM system consists of three main components: **T (Tumor)**: Describes the size and extent of the primary tumor[3]. **N (Node)**: Indicates the number of nearby lymph nodes involved[3]. **M (Metastasis)**: Refers to whether the cancer has spread to distant parts of the body[3]. ## Significance and Application TNM staging serves several important purposes: 1. Predicting prognosis 2. Guiding treatment selection 3. Assessing treatment response 4. Facilitating communication among healthcare professionals 5. Standardizing clinical research[5] ## Staging Process Doctors use various tests to determine the TNM stage, including: - Physical exams - Imaging studies (X-rays, CT scans, PET scans) - Laboratory tests - Pathology reports from biopsies and surgeries[2] ## Stage Grouping Based on the TNM classifications, cancers are typically grouped into stages I-IV, with higher numbers indicating more advanced disease[7]: | Stage | Description | TNM Classification | |-------|-------------|---------------------| | 0 | Carcinoma in situ | Tis, N0, M0 | | I | Localized cancer | T1-T2, N0, M0 | | II | Locally advanced, early | T1-T2, N1, M0 | | III | Locally advanced, late | T1-T4, N2-N3, M0 | | IV | Metastatic cancer | T1-T4, N1-N3, M1 | ## Maintenance and Updates The TNM system is maintained by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC)[1]. It undergoes periodic revisions to incorporate new research and improve its accuracy. The most recent edition, the eighth, was published in 2017[5]. While the TNM system is applicable to most solid tumors, it is not used for leukemia or tumors of the central nervous system[1]. Some cancer types may have specific staging systems tailored to their unique characteristics[4]. Citations: [1] https://en.wikipedia.org/wiki/TNM_staging_system [2] https://www.facs.org/quality-programs/cancer-programs/american-joint-committee-on-cancer/cancer-staging-systems/ [3] https://www.cancer.gov/about-cancer/diagnosis-staging/staging [4] https://www.cancerresearchuk.org/about-cancer/prostate-cancer/stages/tnm-staging [5] https://pmc.ncbi.nlm.nih.gov/articles/PMC6058324/ [6] https://www.cancer.org/cancer/diagnosis-staging/staging.html [7] https://www.ncbi.nlm.nih.gov/books/NBK553187/ [8] https://www.jtcvs.org/article/S0022-5223(17)32136-0/pdf