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Classification of Cancer Patients Beyond TNM

Edwin B. Cox, MD; John Laszlo, MD; Alvin Freiman, MD
JAMA. 1979;242(24):2691-2695. doi:10.1001/jama.1979.03300240031022.
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APPROPRIATE description and classification of the clinical features of the patient with cancer are important prerequisites to clinical management and interpretation of treatment results. Classification serves at least three important functions. First, it is used to provide a prognosis for the individual patient, to establish a basis on which the patient, his family, and the physician may discuss the anticipated course of the disease. A second related use of classification is to guide the physician in his choice of therapy and assist the patient in understanding the potential benefits and risks of alternate forms of treatment. Finally, classification facilitates the use of stratification techniques prior to treatment allocation in clinical trials so that relatively homogeneous subgroups are available for comparison on alternative treatments. A classification system should be chosen according to its ability to fulfill these functions.

Drawbacks of Staging Systems  Staging, or classification according to the anatomical extent of


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