What Is the Prognostic Value of (y)pT and (y)pN?

  • Nadine Ectors


The TNM classification has been modified over the years, up to the seventh edition, attempting to follow the pace of progress and evidence-based developments in oncology. According to TNM authors, the main stage groupings have remained unchanged and are still equivalent to Dukes’ classification. However, major issues relate to subcategories which so-called should still collapse back into those of the 1987 classification and thus are still comparable to Dukes’. The prognostic values of various subcategories do not always achieve the standards of evidence-based that one would/could/should expect. The sequential changes allocate patients to different stages (stage migration) giving lead to therapeutical consequences for the individual patients and difficulties with ongoing clinical trials, databases, registries, etc. Important issues concerning (y)pT and (y)pN to clarify are the tumoural deposits and the number of positive versus the total number of lymph nodes examined and especially the ratio. TNM authors have published principles on ‘the process for continuous improvement of the TNM classification’, a process that is increasingly evidence-based. TNM classification is and should remain a worldwide benchmark for reporting the extent of malignant disease and the major prognostic factor in predicting the outcome of patients.


Lymph Node Rectal Cancer Sentinel Lymph Node Regional Lymph Node Total Mesorectal Excision 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Imaging and PathologyUniversity LeuvenLeuvenBelgium
  2. 2.Activity Center BiobankingUniversity Hospitals LeuvenLeuvenBelgium

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