Reconciliation between the clinical and pathological staging of cancer


This study aims for the reconciliation between models of clinical and pathology-based staging to obtain a more accurate assessment of the main factors of prognostic determinants in the classification for cancer staging. Clinical staging was performed on adenocarcinoma of the colon from five patients with age ranging from 57 to 76 years. Clinical stage was based on determining malignant size, estimating doubling time and deriving hypoxic cell energy using the Emad formula. A pathology-based staging was also performed on the same tumours to determine in vitro estimation of cell proliferation of tumour slices by tritiated thymidine incorporation, hypothesising that the malignant fraction of the detected tumour is the fraction of the tumour unlabelled by the tritiated thymidine. The consistency of results of the factors from the two staging types and their histologic grades were analysed using ANOVA. Perfect correlations between cancer staging factors using the clinical mathematical model and pathology based was confirmed (R 2 = 0.98). This provides a clear-cut criterion for accepting the hypotheses of both models for staging of cancer. It also strengthens the confidence in the equivalence of the energy of the unlabelled fraction of the tumour cells by the tritiated thymidine to that of the malignant fraction of the detected tumour (p < 0.0001). Besides the anatomical extent to which the disease has spread, both the tumour doubling time and the histologic classification are significant prognostic determinants which identify the specific tumour histologic grade which allows physicians to develop customised treatment plans for patients.

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The author declares that there is no conflict of interest concerning this paper.

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Correspondence to Emad Y. Moawad.

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The author is a member of the Korean Society of Nuclear Medicine and of the World Conference of Interventional Oncology (WCIO) USA.

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Moawad, E.Y. Reconciliation between the clinical and pathological staging of cancer. Comp Clin Pathol 23, 255–262 (2014).

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  • Cancer staging
  • Histologic classification
  • Histologic grade
  • Emad formula