bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Prognostic Factor Studies
Authors: Simon Richard
Published: November 2003

Most types of human cancer are heterogeneous with regard to clinical features, natural course, histologic, and molecular characteristics. Better diagnostic classification systems would improve the ability to select an appropriate treatment and facilitate the development of more effective regimens. For example, accurate classification of small breast tumors with regard to metastatic potential would permit many patients to avoid systemic therapy.

The medical literature is filled with reports of prognostic factor discoveries. There are numerous inconsistencies among reports, and for many types of cancer the literature can at best be called confusing. In contrast to clinical trials, there are no standards for prognostic factor studies, and hence it is easy to publish methodologically poor studies in reputable journals. Nearly all prognostic factor studies are “exploratory studies” rather than “confirmatory studies.” Because of problems of multiple significance testing, most conclusions of exploratory analyses will not be correct. The phenomenon of “publication bias” assures that the most positive and erroneous of these studies will be published in reputable journals and receive attention.

Technological developments are likely to make the confusion in the literature of prognostic factor studies much worse. Genomics is providing huge numbers of DNA polymorphisms that can be used as prognostic factors in future studies. DNA microarrays currently permit the expression profiling of tens of thousands of genes for each tumor sample, and these expression levels are potential prognostic factors. It is therefore important for clinical investigators and clinicians to have a better understanding of the flaws of many prognostic factor studies and to establish standards for the type of evidence about a prognostic factor that we should have before accepting the factor in clinical practice. These are the objectives of this chapter.
Psychosocial Factors in Prognosis
Authors: Edmonds Claire V.I. , Cunningham Alastair J.
Published: November 2003

Physicians often encounter patients' belief that psychological factors can predict survival from cancer. However, the research literature is filled with methodological shortcomings and results are often contradictory and problematic. The present brief review discusses psychosocial factors that have shown a relatively consistent relationship to survival in cancer patients.
The Role of Prognostic Factors in Cancer Research
Authors: Groome Patti A. , Mackillop William J.
Published: November 2003

Knowledge about how the characteristics of the individual patients and their diseases will shape their future is useful when they are making decisions about their lives and when they and their doctors are making treatment decisions. When a patient's prognosis changes, new evaluation occurs that can affect further decisions about management. In all instances, knowledge about prognosis improves the quality of decisions by reducing uncertainty. In this chapter, we discuss the role of known prognostic factors in clinical research where the research products facilitate either direct or indirect improvement in the quality of clinical decision making.

Figure 9.1 depicts the uses of the output of various types of clinical research and the role that prognostic factors play in that research. In research that focuses on outcome prediction, formal consideration of the combined role of known prognostic factors through the development of predictive tools can improve the clinician's ability to prognosticate. In research on treatment effectiveness, consideration of known prognostic factors allows the researcher to isolate the effect more efficiently through case selection or through the control of prognostic differences between the treatment and control groups. When subgroups defined by important prognostic factors are analyzed separately, the researcher is able to determine whether treatment is equally effective across the groups, enhancing the clinician's ability to apply research findings to different patients. In research about cancer progression and treatment resistance, identification of clinical prognostic factors can provide a starting point for better understanding of these mechanisms and possibly even disease causation, which may lead to the development of new interventions. Last, in health services research, consideration of the variations in the distributions of prognostic factors among populations of patients permits the study of health system effects.
Oral Cavity, Pharynx, and Larynx Cancer
Authors: Lefebvre Jean‐Louis , Lartigau Eric , Kara Ahmed , Sarini Jérôme
Published: November 2003

Cancers of the oral cavity, pharynx, and larynx occur with a yearly incidence of around 500,000 new cases. They are frequent in developed countries, about equally in North America and the European Community where they have a particularly high incidence in France. Most of these cancers are squamous‐cell carcinomas (SCCs) occurring in rather debilitated patients after a long history of tobacco consumption and alcohol abuse. The vast majority of patients are males aged around 50 years, but there is a tendency to an increasing incidence in females and young adults. In addition, the sociocultural profile of patients suffering from head and neck SCC is often poor. In general, SCCs of the head and neck often proliferate rapidly, are locally aggressive, and carry a high tendency to metastasize to cervical lymph nodes. In presentations with very large lymph nodes, or when lymph nodes are very numerous, the possibility of distant metastasis increases significantly. This natural history explains why that these SCCs are most often diagnosed at an advanced stage, requiring combined therapies. The outcome for this patient population is poor for several reasons: the risk of failure for the index tumor; the risk of developing subsequent SCCs along the upper aerodigestive tract, esophagus, and lung; and the frequency of intercurrent diseases. The risks from comorbity and second cancers arise almost exclusively from the common etiologic association with alcohol and tobacco abuse. SCCs of the oral cavity, pharynx, and larynx are a major public health problem. Apart from large campaigns against tobacco use and alcohol abuse and information that may encourage earlier diagnosis, efforts should be made to assess prognostic factors capable of predicting both outcome and the response to various treatments. In turn, this should help select appropriate therapeutic protocols.
Paranasal Sinus Cancer
Authors: Waldron John N. , Witterick Ian J.
Published: November 2003

Malignant disease arising in the maxillary, ethmoid, frontal, or sphenoid sinuses, collectively known as the paranasal sinuses, is rare. Paranasal sinus cancer represents less than 5% of all head and neck malignancy, which in turn comprises less than 10% of malignancy overall. The majority of paranasal sinus cancers arise within the maxillary sinus (70–80%) followed by the ethmoid sinus (10–20%). Because of this, much of the literature (including the present chapter) focuses on data derived from description of tumors arising at these two sites. Cancers arising in the sphenoid or frontal sinuses are extremely rare. The outcome of patients presenting with paranasal sinus cancer is generally poor, with most centers reporting 5‐year survival rates in the range of 30–40%.

As with any rare disease, the task of reliably identifying and validating independent prognostic factors for paranasal sinus cancer is complicated by the lack of prospectively collected data and the variability of data reported in the retrospective literature that spans many decades, with most series containing relatively small numbers of patients. Reports frequently describe patients with a wide range of tumor extent and histology treated with variable treatment approaches. Outcomes are often analyzed and reported with respect to different endpoints. Prognostication and empiric management recommendations are regularly based on conclusions drawn from the comparison of inhomogeneous treatment groups. In this chapter we attempt to identify prognostic factors that are supported by currently available data and, of equal importance, those that do not enjoy this support.
Nasopharyngeal Carcinoma
Authors: O'Sullivan Brian , Chong Vincent
Published: November 2003

Nasopharyngeal carcinoma (NPC) is unusual in several ways. Its epidemiology, associated with ethnicity, genetic predisposition, viral, and environmental dietary exposure, is unique in itself. In addition, the predilection for certain geographic areas, with relative sparing of adjacent regions is noteworthy. Unjustly perhaps, NPC poses a formidable public health hazard to countries that are relatively compromised in their ability to provide the technical diagnostic and therapeutic approaches considered to be necessary for optimal management today. However, what sets it apart from most diseases is the anatomic challenge it presents to the oncology team because of the proximity of the nasopharynx to critical anatomic structures and the high predilection for distant metastasis once the primary and regional lymph‐node areas are extensively involved, which is all too frequent.

In this chapter we discuss prognostic factors of importance in the management of NPC using the classification proposed earlier in this book. Factors will be considered by whether they relate to the
disease
itself, the patient (or
host
), or the
environment
which influences the opportunity for optimal treatment and diagnosis. The classification may not always apply since, in the case of NPC, there may be overlap among factors and arbitrary placement of factors may be necessary. We will also attempt to categorize the available evidence into factors which are essential to our ability to treat the disease (
essential
factors), those which add valuable information about the disease but do not affect treatment decisions (
additional
factors), and finally those that are being described and may provide important understanding of disease behavior and therapeutic approaches in future years. In the interest of relevance to the treatment of the disease, and for brevity, the discussion of the final group of factors (those termed
new and promising
), will be restricted to experience of patient outcome. Therefore, preclinical studies will not receive attention.

Special attention to the classification of stage of disease will be given. This is because for NPC anatomic features are so important that a relevant and reproducible system of classification merits attention above other prognostic factors. In fact, few diseases received the same level of attention in the preparation of the 5th edition (TNM) stage classification of the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). A major revision of the NPC stage was accomplished by a substantial collaborative consultation among radiation oncologists in Southeast Asia, with support from diagnostic radiologists, pathologists, and surgeons there and elsewhere.
Cancer of the Esophagus
Authors: Stein Hubert J. , Feith Marcus
Published: November 2003

In contrast to other tumors of the gastrointestinal tract, independent prognostic factors have only recently been identified in patients with esophageal carcinoma. This is because most studies assessing the prognosis of patients with esophageal cancer were retrospective univariate analyses of small patient populations that were usually not treated according to standardized protocols. Due to interrelations between various patient‐ and tumor‐related factors and their alterations by therapeutic strategies, the independent prognostic effect of individual parameters cannot be deducted from these analyses. This can only be achieved by multiple stepwise regression analysis applied to a sufficiently large patient population that has undergone standardized treatment and has been followed for a sufficiently long period of time. Studies that meet these criteria have become available only during the past decade. The chapter critically reviews the currently available literature on prognostic factors in patients with esophageal cancer, which are classified into the three categories: (1) tumor‐ or disease‐related prognostic factors; (2) patient‐related factors; and (3) environment‐ or treatment‐related factors.
Malignant Thymoma
Authors: Payne David G.
Published: November 2003

The thymus gland, located in the anterior mediastinum, plays a crucial role in the development of immunological competence during fetal development and infancy. It is composed of both thymic epithelial cells and lymphoid cells, many originating in the bone marrow. During the development period, the complex system of T lymphocytes evolves, underpinning functions of foreign antigen processing and self‐recognition of the organism's histocompatibility complex. The gland undergoes significant involution in childhood, resulting in a twin‐lobed organ composed of fibrous, lymphatic, and epithelial elements. Its function in the adult is unknown; however, evidence for its immunologic role is seen in the involution associated with various disorders, including autoimmune diseases and AIDS, and conversely in the immunodeficiency associated with primary thymic aplasia. Tumors of the thymus are unusual, but account for about 15% of mediastinal tumors (or over 50% of masses in the anterior mediastinum). These neoplasms contain varying proportions of lymphocytes and of thymic epithelial cells, with a generally benign appearance. However, all thymomas are considered to be malignant tumors possessing differing degrees of aggressivity, or invasiveness. When frank cytologic features of malignancy are seen in epithelial cells, the tumor is regarded as a thymic carcinoma.

Clinical features typically relate to the size of the mass and proximity to other organs. The introduction of the Masaoka classification, based on the extent of local invasion by malignant cells, was an important advance in the addressing the need for comparative studies. However, the association of thymoma with various autoimmune disorders is distinctive and possibly prognostic. These conditions include myasthenia gravis, hypogammaglobulinemia, and red‐cell aplasia. Interestingly these syndromes are not associated with thymectomy in another context. A variety of other paraneoplastic syndromes are seen; about 40% of thymoma patients have one, and many suffer from multiple such disorders. For the purpose of this discussion these will be considered to be tumor‐related factors. Note that in accordance with the guidelines for this text, only factors that are required for clinical decision making are considered “essential.”
Skin Cancer
Authors: Poulsen Michael
Published: November 2003

The great majority of skin cancers will be cured and this has resulted in a certain degree of complacency in its management. Despite the overall favorable outlook there remains a subset of patients who remain at higher risk of relapse and indeed may even succumb to the disease. There are many prognostic factors known, but the relationships between these variables are complex and it is difficult to differentiate the independent variables from the dependent ones.

In contrast to the low recurrence rate, the risk of subsequent skin cancer elsewhere is about 50% at 5 years. The factors, which are prognostic for recurrence, are not the same as the factors, that predict for further skin cancer. Fair skin, male gender, high accumulation of solar exposure, and multiple previous basal cell carcinoma (BCC) or squamous cell carcinomas (SCCs) predict for further skin cancers.

The major types of nonmelanomatous skin cancer (NMSC) to be considered in this chapter are BCC, SCC and Merkel cell carcinoma (MCC).
Squamous‐cell Carcinoma of the Penis
Authors: Horenblas Simon
Published: November 2003

Squamous‐cell carcinoma (SCC) of the penis is a rare malignancy, accounting for less than 1% of urological cancers in males in Western countries. From all cancers affecting the penis more than 95% consists of SCC. Rare disorders like melanoma and soft tissue disease will not be considered in this summary. Most information regarding clinical course and prognostic factors has been based on relatively few series and case histories; there are no known prospective clinical trials in the field of penile cancer. Therefore bias, on the basis of referral pattern and institutional treatment preferences, cannot be ruled out. Moreover, there are only a few publications analyzing clinical data with multivariate prognostic factor analysis. For classification purposes, at least six classification systems of SCC of the penis have been proposed. Because the TNM system of the International Union Against Cancer (UICC) is considered the most universal used classification, the others will not be considered here.
Bladder Cancer
Authors: Bassi PierFrancesco , Pagano Francesco
Published: November 2003

Transitional cell carcinoma of the bladder is the second most common malignancy of the genitourinary tract, and the second most common cause of death among all genitourinary tumors, the 11th most common cancer on a worldwide basis, accounting for 3–4% of all malignancies. Annually, about 220,000 new cases are being diagnosed; three‐fourths of these patients are men and a disproportional (two‐thirds) number of cases occur in developed countries.

It's important to underline that a distinction between superficial bladder cancer (stages Ta, T1, Tis) and invasive bladder cancer (stages T2–T4) must be taken into account due to the different prognosis and treatment approaches. As a matter of fact, bladder cancer is a heterogeneous disease with considerable variations of its natural history with 5‐year survival rates ranging from 97% to 98% of a single, well‐differentiated, and small papillary tumor to less than 10% of an invasive bladder cancer extending throughout the bladder wall with distant metastases. Among superficial bladder cancer, tumor recurrence after initial therapy varies from 30% in patients with a solitary papillary tumor to more than 90% in patients with multiple tumors. Intense research efforts are being made to identify and characterize the different types of bladder cancer and their variable biological potential. The desire to predict which superficial bladder cancer will recur or progress to invasive cancer, and which invasive bladder cancer will metastatize has spurred the development of a variety of potential prognostic factors.

In this chapter we provide a contemporary review of such prognostic factors with a particular emphasis to the reliable or potential use in the clinical practice.
Non‐
H
odgkin's Malignant Lymphoma
Authors: Crump Michael , Gospodarowicz Mary
Published: November 2003

The non‐Hodgkin's lymphomas (NHLs) are a diverse group of diseases with large variation in tumor biology and course of disease. The 1980s and 1990s brought a great increase in our knowledge of the biology of the immune system. Insights into the immunology and molecular genetics of NHL have led to the recognition of a number of new pathological entities, with unique natural histories. In addition, the clinical approach to patients with NHL has relied increasingly on aggregate assessment of prognostic factors, rather than single attributes such as disease stage, presence of extranodal involvement, presence of constitutional symptoms, or specific biochemical abnormalities. Furthermore, it is increasingly recognized that these biological attributes are surrogate measures of a tumor's growth and invasion potential, the host's response to the tumor, and the host's ability to tolerate treatment. A better understanding of the significance of molecular and immunological attributes of lymphoma will hopefully replace these clinical surrogates in refining NHL's prognosis and therapy more precisely in the future.
Pediatric Cancers
Authors: Marcus Karen J. , Hodgson David
Published: November 2003

Pediatric cancers include a broad spectrum of diseases. Cancer is diagnosed in only 8400 children in the United States less than 15 years of age annually, although death from cancer is the second major cause of mortality in developed countries. Childhood cancers differ from adult cancers in their origins and histologic subtypes, their etiologies, their response to treatment, and the outcomes. In the adult population, epithelial cancers are most common and many are related to environmental carcinogens. In contrast, pediatric malignancies more commonly arise in hematopoietic tissue or in the central nervous system (CNS).

The most common pediatric malignancies are acute leukemia, non‐Hodgkin's lymphoma, Hodgkin's disease, and primary CNS tumors. Neuroblastoma, Wilms' tumor, rhabdomyosarcoma, and retinoblastomas are the most common solid tumors occurring in children. The etiology of most childhood malignancies is unknown, although some solid tumors do occur in association with recognized genetic defects. Bilateral retinoblastoma, for instance, occurs in children with mutations in the retinoblastoma tumor suppressor gene
RB1
. Wilms' tumor occurs in association with mutations in the
WT1
gene in the Denys‐Drash Syndrome. Rhabdomyosarcomas are seen in children with the LiFraumeni syndrome with
p53
gene mutations.

Major advances in cancer genetics and the molecular biology of cancer have been gained through research in pediatric malignancies. Despite its rarity in comparison to adult malignancies, many of the most important discoveries about cancer biology and cancer genetics have come from research in pediatric cancers. In addition, the role of prognostic factors in determining treatment for an individual patient is best exemplified by neuroblastoma which is discussed in this chapter. At the present time, only a limited number of cancers in children have prognostic factors that have been prospectively evaluated and confirmed. In this chapter, we review those pediatric cancers that have clearly defined prognostic factors. The understanding of cancer genetics gained from the study of pediatric cancers, the identification of prognostic factors, their confirmation in clinical trials, and their widespread acceptance can be viewed as a paradigm for prognostic factors in cancer patient management.
Site‐Specific Recommendations for
p
T
and
p
N
Authors: Wittekind Ch. , Henson D. E. , Hutter R. V. P. , Sobin L. H.
Published: November 2003

This chapter is an expansion of the following general rules of the TNM system (TNM Classification 1997 [13]):

2b. Pathological assessment of the primary tumour (pT) entails a resection of the primary tumour or biopsy adequate to evaluate the highest pT category. The pathological assessment of the regional lymph nodes (pN) entails removal of nodes adequate to validate the absence of regional lymph node metastasis (pN0) and sufficient to evaluate the highest pN category.

4. If there is doubt concerning the correct T, N or M category to which a particular case should be allotted, then the lower (i.e., less advanced) category should be chosen.

In the TNM Classification of 1997 [13] these general rules have been specified for breast cancer only. Analogous definitions for the pN0 category of other tumour sites are given in the 1997 TNM Classification, except for bone, soft tissues, urological, and ophthalmic tumours.

The numbers of lymph nodes given in the different tumour sites are considered adequate for staging. If the examined lymph nodes are negative but the number ordinarily resected is not met, classify as pN0. The number of nodes examined and the number involved by tumour should be recorded in the pathology report [1, 2, 4, 6, 7, 9]. This information may also be added in parentheses, e.g., for colorectal carcinoma pN0 (0/11) or pN1 (3/10).

In many tumour sites, the number of involved regional lymph nodes indicates differences in prognosis. For details, see pN–Regional Lymph Nodes. A correlation exists between the number of examined lymph nodes and the pN classification. With increasing number of examined lymph nodes a higher frequency of lymph node‐positive cases is found and‐in tumour sites where more than one positive pN category is provided‐a greater proportion of higher pN categories can be observed [3, 11]. Therefore, the number of examined lymph nodes reflects the reliability of the pN classification.
New
TNM
Classifications Recommended for Testing
Authors: Wittekind Ch. , Henson D. E. , Hutter R. V. P. , Sobin L. H.
Published: November 2003

This chapter contains proposals for new classifications as follows:

General

Perineural invasion

Specific

Gastrointestinal sarcomas

Malignant thymoma

Cranial and facial bones

Cutaneous T‐cell lymphoma

Chronic myeloid leukaemia

Primary liver carcinoma in infants and children

Adrenal cortical carcinoma

Liver metastasis of colorectal carcinoma

Gastrointestinal malignant lymphomas

These new classifications are provisional. Testing by several institutions and on large numbers of patients is needed before general acceptance can be recommended. Those having relevant data, published or not, on these classifications are invited to contact the TNM Prognostic Factors Project Committee of the UICC.
Introduction
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is the most widely used means for classifying the extent of cancer spread. TNM Classification of Malignant Tumours, Sixth Edition provides the new, internationally agreed‐upon standards to describe and categorize cancer stages and progression. Published in affiliation with the International Union Against Cancer (UICC), this guide contains important new and updated organ‐specific classifications that oncologists and other professionals who treat patients with cancer must use to adequately classify tumours for prognosis and treatment.

This introduction provides a history of the TNM system, the principles of the classification of cancers and general rules of the TNM system applicable to all sites. Headings used in the TNM system to classify tumours for specific anatomical regions and sites are also provided with definitions.
Larynx
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Small Intestine
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Colon and Rectum
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Anal Canal
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Liver
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Gallbladder
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Lung and Pleural Tumours
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The classifications apply to carcinomas of the lung and malignant mesothelioma of pleura.

Each site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading where applicable

Stage grouping

Summary
Soft Tissues
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Gynaecological Tumours
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The following sites are included:

Vulva

Vagina

Cervix uteri

Corpus uteri

Ovary

Fallopian tube

Gestational trophoblastic tumours

Cervix uteri and corpus uteri were among the first sites to be classified by the TNM system. The “League of Nations” stages for carcinoma of the cervix have been used with minor modifications for over 50 years, and, because these are accepted by the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO), the TNM categories have been defined to correspond to the FIGO stages. Some amendments have been made in collaboration with FIGO, and the classifications now published have the approval of the FIGO, UICC, and the national TNM committees including the AJCC.

Each site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

Stage grouping

Summary
Vulva
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Urological Tumours
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The following sites are included:

Penis

Prostate

Testis

Kidney

Renal pelvis and ureter

Urinary bladder

Urethra

Each site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

Distant metastasis

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading where applicable

Stage grouping

Summary
Penis
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Ophthalmic Tumours
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

Tumours of the eye and its adnexa are a disparate group including carcinoma, melanoma, sarcomas, and retinoblastoma. For clinical convenience they are classified in one section.

The following sites are included:

Eyelid (eyelid melanoma is classified with skin tumours)

Conjunctiva

Uvea

Retina

Orbit

Lacrimal gland

For histological nomenclature and diagnostic criteria, reference to the WHO histological classification (Campbell, RJ: Histological typing of tumours of the eye and its adnexa, 2nd ed. Springer, Berlin, 1998) is recommended.

Each tumour type is described under the following headings:

Rules for classification with the procedures for assessing the T, N, and M categories

Anatomical sites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading where applicable

Stage grouping where applicable

Summary
Carcinoma of Eyelid
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Malignant Melanoma of Conjunctiva
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Malignant Melanoma of Uvea
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

The TNM system is used to describe and classify cancer stages and progression based on the assessment of three components:

T

The extent of the primary tumour

N

The absence or presence and extent of regional lymph node metastasis

M

The absence or presence of distant metastasis.

TNM classification for the above site is described under the following headings:

Rules for classification with the procedures for assessing T, N, and M categories; additional methods may be used when they enhance the accuracy of appraisal before treatment

Anatomical sites and subsites where appropriate

Definition of the regional lymph nodes

TNM Clinical classification

pTNM Pathological classification

G Histopathological grading

Stage grouping

Summary
Non‐
H
odgkin Lymphomas
Authors: Sobin L.H. , Wittekind Ch.
Published: November 2003

As in Hodgkin lymphoma, at the present time it is not considered practical to propose a TNM classification for non‐Hodgkin lymphomas. Since no other convincing and tested staging system is available, the Ann Arbor classification is recommended with the same modification as for Hodgkin lymphoma.
Assessing participant learning in online environments
Authors: Benson Angela D.
Published: November 2003

Assessing participant learning in online environments provides benefits and challenges. Fortunately, the
available technology tools allow for a wide range of assessment techniques.
Complex‐Surfactant‐Assisted Hydrothermal Route to Ferromagnetic Nickel Nanobelts
Authors: Liu Z. , Li S. , Yang Y. , Peng S. , Hu Z. , Qian Y.
Published: November 2003

Ferromagnetic metal nanobelts are reported to have been synthesized for the first time in solution by a simple and mild hydrothermal method. The nickel nanobelts (see Figure), which typically had a thickness of ∼15 nm, width of 500–1000 nm, and length of up to 50 μm, showed remarkably enhanced ferromagnetic properties. The method is expected to be transferable to other transition metals.
Preparation and degradation of PLA/chitosan composite materials
Authors: Li Lihua , Ding Shan , Zhou Changren
Published: November 2003

As scaffold material, poly(lactic acid) (PLA) has several obvious weaknesses, such as fast biodegradation, acidic degradation product, and hydrophobicity. To solve these problems, a series of PLA/chitosan composite materials was prepared in this study. SEC observation, porosity tests and contact angle measurements showed that the materials were hydrophilic and had appropriate porosity and structure, which were favorable to the cell growth. Degrading tests in vitro indicated that the degrading speeds of the materials were slower than that of PLA, and the materials could keep adjacently litmusless, certain shape and mechanical properties. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 274–277, 2004
Characterization of structural changes in thermally enhanced Kevlar‐29 fiber
Authors: Downing James W. , Newell James A.
Published: November 2003

This exploratory investigation examined the structural mechanism accounting for the enhanced compressive properties of heat‐treated Kevlar‐29 fibers. A novel theory was set forth that hydrogen‐bond disruption and concurrent misorientation of crystallites may account for the observed augmentation of compressive properties. To examine the said theory, as‐received Kevlar‐29 fibers were characterized by thermogravimetric analysis and differential scanning calorimetry in an effort to determine if crosslinking and/or hydrogen‐bond disruption was responsible for the improved behavior in compression. Additionally, Kevlar‐29 fibers that had been exposed to treatment temperatures of 400, 440, and 470°C were profiled by Fourier transform infrared spectrophotometry to determine if crosslinking and/or hydrogen‐bond obfuscation had been promoted. The results indicate that both mechanistic changes occurred within the Kevlar‐29, albeit in different regions of the rigid‐rod polymer. In particular, heat treatment of poly‐p‐phenylene terephthalamide appears to have resulted in crosslinking of its skin region and hydrogen‐bond disruption within the core realm. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 417–424, 2004
Synthesis of hexa‐allylamino‐cyclotriphosphazene as a reactive fire retardant for unsaturated polyesters
Authors: Kuan Jenn‐Fong , Lin King‐Fu
Published: November 2003

A phosphazene derivative, hexa‐allylamino‐cyclotriphosphazene (HACTP), was synthesized through the aminolysis of hexa‐chloro‐cyclo‐triphosphazene with excess allylamine. HACTP is a soluble light‐brown crystalline solid, which melts at 90°C. It was reactive after melt but decomposed at 236°C. When it was incorporated into the resin formulations of unsaturated polyesters, it acted as a reactive flame retardant. The oxygen index was increased from 20.5 to 25.2, rating from the flammable to self‐distinguishable scale. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 697–702, 2004
Release of diclofenac through gluteraldehyde crosslinked poly(vinyl alcohol)/poly(acrylic acid) alloy membranes
Authors: Şanli Oya , Asman Gülsen
Published: November 2003

A controlled‐release preparation of diclofenac sodium for transdermal administration has been developed. Poly(vinyl alcohol) (PVA) and PVA/poly(acrylic acid) (PAA) alloy membranes were prepared from a solvent‐casting technique using different PVA/PAA (v/v) ratios. The release of the drug from the membrane was evaluated under in vitro conditions at pH 7.4. The delivery system provided linear release without time lag, burst effect, and boundary layer resistance. Effects of variables such as film thickness and PVA/PAA ratio on the permeation behavior of the polymeric membranes were discussed. The optimal PVA/PAA was determined as 50/50. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 72–77, 2004
Influence of crystallinity in the curing mechanism of PVC plastisols
Authors: López J. , Balart R. , Jiménez A.
Published: November 2003

The influence of the crystalline areas observed in poly(vinyl chloride) (PVC) the mechanical and thermal properties of PVC plastisols was studied. Several industrial‐degree PVC resins were used to obtain a broad range of molecular weights and processing conditions for PVC plastisols. The gelation process was fully studied at different temperatures and was related to the existence of crystalline areas at high temperatures, even near the glass transition. A simple explanation of the phenomena observed during the gelation of plasticized PVC is proposed, according to the variation in the mechanical and thermal properties at different temperatures. The final gelation was obtained at 140–150°C, which was a lower temperature than those at the beginning of the thermal degradation process. The thermodynamic aspects of the gelation of plasticized PVC were mainly controlled by the PVC resin properties, whereas the plasticizer only influenced the diffusion and stability of the material. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 538–544, 2004
Newsprint paper waste as a fiber reinforcement in rubber composites
Authors: Nashar D. E. E. , Abd‐El‐Messieh S. L. , Basta A. H.
Published: November 2003

The investigation of the economical use of lignocellulose waste, which is one of the environmental problems facing third‐world nations, is ongoing. In this study, we intended to increase the use of newsprint fibers in the rubber industry. For this reason, we treated newsprint fibers with sodium silicate and magnesium chloride, and we examined the water retention values and thermal degradation analyses of the treated fiber waste. The activation energy of degradation was evaluated with the Coats–Redfern method of analysis. The effects of the addition of different amounts [0–60 parts per hundred parts of rubber by weight (phr)] of untreated and treated newsprint fibers on both the electrical and mechanical properties of two different types of rubber (natural rubber and acrylonitrile rubber) were studied. This study led us to the conclusion that the addition of treated newsprint fiber waste at a concentration of 40 phr could lead to an end product characterized by good electrical and mechanical properties. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 469–478, 2004
Influence of filler–rubber interactions on the viscoelastic properties of carbon‐black‐filled rubber compounds
Authors: Léopoldès J. , Barrès C. , Leblanc J. L. , Georget P.
Published: November 2003

The specific role of filler–rubber interactions in dynamic properties was investigated. Natural rubber compounds, filled with N330 carbon black, were used, and the filler surface was modified through a gas treatment in the solid phase. The effects of this filler surface treatment on the dynamic properties were systematically studied at equal filler dispersion levels. The dynamic properties were assessed for both uncured and vulcanized compounds, and a number of advanced investigative techniques were used to characterize not only the modification of the carbon particle surface by an oxidative treatment but also the structure of the filled rubber compounds. Particular attention was paid to techniques that gave access to the segmental mobility to explain the benefit observed with modified carbon black. A molecular interpretation, based on NMR measurements, was considered that took into account physicochemical parameters. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 577–588, 2004