Talk:TNM

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Like so many systems and classifications in medicine, there is urgent need for internationally agreement, partly to facilitate research and partly for fruitful international scientific and clinical co-operation. The TNM system is not always as internationally cooperative as may first seem. One recent example that struck me was the changes made to the definition of lymph node metastases and vascular invasion in TNM6 from TNM5. These are thought by many in the UK to be unsupported by evidence, unneccesary and indeed potentially dangerous (P Quirke, E Morris (2007)- Reporting colorectal cancer; Histopathology 2007: 50 (1), 103–112) and I entirely agree with their arguments. The current UK guidance in reporting colorectal cancer recommends usage of TNM5 in preference to TNM6. If the TNM system was a bit less Americo-centric then I'm sure that it would feature more prominently and have a greater part to play in the research and clinical management of cancer. My suggestion to the AJCC would be to ensure that any changes made to TNM are made by international consensus and also that any changes made are backed by rigorous evidence.