Attending NCRA on Friday April 7th with the AJCC experts was truly humbling. These are the writers and the contributors to the AJCC staging helping to guide the staging principles, deciding the best stage and how to assign the stage. Donna Gress completed an impressive presentation on the AJCC 8th edition general rules and guidelines.
The biggest take home point for me was how much reading registrars will be doing prior to assigning a stage or ensuring the managing physicians’ stage is correct. Not only will we be reading the chapter containing the correct site and histology, but we must also be familiar with the general rules in Chapter One. Chapter One has been extensively reviewed and revised to help clarify the manual rules.
Major changes to some of the chapters and sites have been made. Melanoma thickness is now measured to 0.1mm instead of 0.01mm for staging. Breast cancers with sizes greater than 1.0mm and less than or equal to 1.4mm should not be rounded down to 1.0mm as this qualifies as T1mic and is not indicative of the size and should be sized as greater than micromets. Soft tissue sarcoma has been split into several chapters depending on where the sarcoma originates to more accurately describe the prognosis. Finally, Clinical Tis and Ta can be assigned for the 8th edition. These are only a few of the major changes and again the registrars will be required to read the manual carefully not only to determine the chapter that is utilized for the cancer, but also that the general rules are followed.
This Recap was provided by Roberta Adams, CTR- Quality Control Manager for the Registry Partners- Oncology Services Division