Ann Arbor staging

Jump to: navigation, search

WikiDoc Resources for Ann Arbor staging

Articles

Most recent articles on Ann Arbor staging

Most cited articles on Ann Arbor staging

Review articles on Ann Arbor staging

Articles on Ann Arbor staging in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Ann Arbor staging

Images of Ann Arbor staging

Photos of Ann Arbor staging

Podcasts & MP3s on Ann Arbor staging

Videos on Ann Arbor staging

Evidence Based Medicine

Cochrane Collaboration on Ann Arbor staging

Bandolier on Ann Arbor staging

TRIP on Ann Arbor staging

Clinical Trials

Ongoing Trials on Ann Arbor staging at Clinical Trials.gov

Trial results on Ann Arbor staging

Clinical Trials on Ann Arbor staging at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Ann Arbor staging

NICE Guidance on Ann Arbor staging

NHS PRODIGY Guidance

FDA on Ann Arbor staging

CDC on Ann Arbor staging

Books

Books on Ann Arbor staging

News

Ann Arbor staging in the news

Be alerted to news on Ann Arbor staging

News trends on Ann Arbor staging

Commentary

Blogs on Ann Arbor staging

Definitions

Definitions of Ann Arbor staging

Patient Resources / Community

Patient resources on Ann Arbor staging

Discussion groups on Ann Arbor staging

Patient Handouts on Ann Arbor staging

Directions to Hospitals Treating Ann Arbor staging

Risk calculators and risk factors for Ann Arbor staging

Healthcare Provider Resources

Symptoms of Ann Arbor staging

Causes & Risk Factors for Ann Arbor staging

Diagnostic studies for Ann Arbor staging

Treatment of Ann Arbor staging

Continuing Medical Education (CME)

CME Programs on Ann Arbor staging

International

Ann Arbor staging en Espanol

Ann Arbor staging en Francais

Business

Ann Arbor staging in the Marketplace

Patents on Ann Arbor staging

Experimental / Informatics

List of terms related to Ann Arbor staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

Ann Arbor staging is the staging system for lymphomas, both in Hodgkin's lymphoma (previously called Hodgkin's Disease) and Non-Hodgkin lymphoma (abbreviated NHL). It was initially developed for Hodgkin's, but has some use in NHL. It has roughly the same function as TNM staging in solid tumors.

The stage depends on both the place where the malignant tissue is located (as located with biopsy, CT scanning and increasingly positron emission tomography) and on systemic symptoms due to the lymphoma ("B symptoms": night sweats, weight loss of >10% or fevers).

Principal Stages

The principal stage is determined by location of the tumor:

  • Stage I indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
  • Stage II indicates that the cancer is located in two separate regions, an affected lymph node or organ within the lymphatic system and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm.
  • Stage III indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.
  • Stage IV indicates diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.

Modifiers

These letters can be appended to some stages:

  • A or B: the absence of constitutional (B-type) symptoms is denoted by adding an "A" to the stage; the presence is denoted by adding a "B" to the stage.
  • E: is used if the disease is "extranodal" (not in the lymph nodes) or has spread from lymph nodes to adjacent tissue.
  • X: is used if the largest deposit is >10 cm large ("bulky disease"), or whether the mediastinum is wider than 1/3 of the chest on a chest X-ray.

Type of staging

The nature of the staging is (occasionally) expressed with:

  • CS - clinical stage as obtained by doctor's examinations and tests.
  • PS - pathological stage as obtained by exploratory laparotomy (surgery performed through an abdominal incision) with splenectomy (surgical removal of the spleen). Note: exploratory laparotomy has fallen out of favor for lymphoma staging.

Limitations

The staging does not take into account the grade (biological behavior) of the tumor tissue. The prognostic significance of bulky disease, and some other modifiers, were introduced with the "Cotswolds modification" (Lister et al 1989).

History

The Ann Arbor classification is named after Ann Arbor, Michigan, where the Committee on Hodgkin's Disease Staging Classification met in 1971; it consisted of experts from the USA, UK, Germany and France, and replaced the older Rye classification from a 1965 meeting (Rosenberg 1966). The Cotswolds modification followed after a 1988 meeting in the UK Cotswolds. [1]

References

  • Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin’s disease staging classification. Cancer Res 1971;31:1860-1. PMID 5121694.
  • Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, Rosenberg SA, Coltman CA, Tubiana M. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol 1989 Nov;7(11):1630-6. PMID 2809679.
  • Rosenberg SA. Report of the committee on the staging of Hodgkin’s disease. Cancer Res. 1966;26:1310.
  1. Mauch, Peter (1999). Hodgkin's Disease. Lippincott Williams & Wilkins. pp. 223–228. ISBN 0-7817-1502-4. Unknown parameter |coauthors= ignored (help)

External Link

  • Citation classics (PDF, Current Contents/Clinical Practice 1983;50:22) - Prof Paul P. Carbone commenting on the impact of the Ann Arbor classification (from the Citation Classics library)

de:Ann-Arbor-Klassifikation



Linked-in.jpg