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CA Cancer J Clin. 2017 Mar;67(2):93-99. doi: 10.3322/caac.21388. Epub 2017 Jan 17.

The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging.

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Professor and Chairman, UTHSC Gerwin Chair for Cancer Research, Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN.
Medical Director, Cancer Data Services, Levine Cancer Institute, Charlotte, NC.
Vice President, Healthcare Outcomes and Policy, Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY.
Professor of Oncology, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY.
Chief Medical Officer, Complex Adaptive Systems Initiative, Arizona State University, Scottsdale, AZ.
Professor of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Professor of Surgery and Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Radiation Oncologist, Greater Baltimore Medical Center, Baltimore, MD.
Eighth Edition Project Manager and Managing Editor, American Joint Committee on Cancer, Chicago, IL.
Technical Specialist and Technical Editor, American Joint Committee on Cancer, Chicago, IL.
Section Chief of Surgical Oncology and Professor of Surgery, University of Washington, Seattle, WA.
Medical Director, American Joint Committee on Cancer, Chicago, IL.


The American Joint Committee on Cancer (AJCC) staging manual has become the benchmark for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. Many view the primary role of the tumor, lymph node, metastasis (TNM) system as that of a standardized classification system for evaluating cancer at a population level in terms of the extent of disease, both at initial presentation and after surgical treatment, and the overall impact of improvements in cancer treatment. The rapid evolution of knowledge in cancer biology and the discovery and validation of biologic factors that predict cancer outcome and response to treatment with better accuracy have led some cancer experts to question the utility of a TNM-based approach in clinical care at an individualized patient level. In the Eighth Edition of the AJCC Cancer Staging Manual, the goal of including relevant, nonanatomic (including molecular) factors has been foremost, although changes are made only when there is strong evidence for inclusion. The editorial board viewed this iteration as a proactive effort to continue to build the important bridge from a "population-based" to a more "personalized" approach to patient classification, one that forms the conceptual framework and foundation of cancer staging in the era of precision molecular oncology. The AJCC promulgates best staging practices through each new edition in an effort to provide cancer care providers with a powerful, knowledge-based resource for the battle against cancer. In this commentary, the authors highlight the overall organizational and structural changes as well as "what's new" in the Eighth Edition. It is hoped that this information will provide the reader with a better understanding of the rationale behind the aggregate proposed changes and the exciting developments in the upcoming edition. CA Cancer J Clin 2017;67:93-99.


American Joint Committee on Cancer (AJCC); TNM staging; application programing interface; cancer stage; component content management system; electronic health record; precision medicine; prognostic factors; risk assessment models

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