R.V.P. Hutter – författare

This 1993 supplement facilitates uniform application of the TNM classification. The supplement provides explanations and examples that will solve practical problems when using TNM on a daily basis. It spells out the requirements for pathological classification (pT, pN) and contains recommendations for classification of new tumour sites and entities which are not yet formally included in the TNM system. It also includes proposals for optimal expansion of TNM subsets where more detailed data are needed without altering the basic rules of the TNM classification.

The fourth edition of the TNM Classification was published in 1987,1 and a revision in 1992.2 It was the result of efforts by all national TNM Committees towards a worldwide uniform classification. The classifica­ tion criteria are identical with the fourth edition of the Manual for 3 Staging of Cancer of the American Joint Committee on Cancer (AJCC). Although the classification has found wide acceptance, some workers have pointed out that individual definitions and rules for staging are not sufficiently detailed. This can lead to inconsistent application of the clas­ sification. the antithesis of standardization. This source of differences in interpretation applies not only to the classification of individual organs but also to the general rules of the system, especially to the definitions of the requirements for the pathological classification (pT, pN). These are specified only for carcinoma of the breast; for other sites, reference must be made back to the general rules. which can lead to variable interpreta­ tions. The TNM Project Committee of the UICC has addressed this prob­ lem and collected and considered the criticisms and suggestions from the national TNM Committees as well as from cancer registries, oncolo­ gical associations and individual users. The result was the decision to complement the 4th edition of the TN M Classification 1.2. 3 with the publi­ cation of a TNM Supplement containing recommendations for the uni­ form use of TNM.

In 1938 the League of Nations Health Organization published an Atlas Illustrating the Division of Cancer of the Uterine Cervix into Four Stages (edited by J. Heymann, Stockholm). Since this work appeared, the idea of visual representation of the anatom­ ical extent of malignant tumours at the different stages of their development has been repeatedly discussed. At its meeting in Copenhagen in July 1954, the UICC adopted as part of its programme "the realization of a clinical atlas". However, the time to publish the planned book of illustrations was not ripe until the national committees and international or­ ganizations had officially recognized the 28 classifications of malignant tumours at various sites as presented in the third edi­ tion of the TN M Booklet edited by M. Harmer (TNM Classifica­ tion of Malignant Tumours, 1978). This was all the more impor­ tant since publication of the Booklet was followed in 1980 by publication of A Brochure of Checklists, edited by A. H. Sellers, a further aid in the practical application of the TNM system. The TNM Atlas (first edition 1982, second edition 1985) was the third of the aids intended to fulfil the one ultimate purpose of making the classification of the anatomical extent of malignant tumours as much a routine procedure as histological typing and grading.

Die vorliegende 4. Auflage des TNM-Atlas beinhaltet alle Ergänzungen und Veränderungen der fünften Auflage der TNM-Klassifikation Maligner Tumore und stellt den derzeitigen Standard der TNM-KLassifikation dar, der von allen nationalen TNM-Kommittees akzeptiert und angewandt wird. Zahlreiche Abbildungen erleichtern die praktische Anwendung des TNM - Systems für alle onkologisch tätigen Ärzte.

Die TNM-Klassifikation ist die weltweit am häufigsten verwendete und international einheitliche Klassifikation der anatomischen Ausbreitung maligner Tumoren. Sie hilft 1. dem Kliniker bei der Behandlungsplanung, 2. bei der Stellung der Prognose 3. bei der Auswertung der Behandlungsergebnisse, 4. beim Informationsaustausch zwischen Behandlungszentren, und 5. die kontinuierliche Erforschung der menschlichen Krebserkrankungen zu verbessern. Im TNM-Atlas werden die Regeln für die Klassifikation der verschiedenen Tumoren durch schematische bildliche Darstellungen veranschaulicht und es wird somit die praktische Anwendung des TNM-Systems erleichtert. Die 3. Auflage enthält alle Neuerungen der letzten Jahre einschließlich neuer Klassifikationen für Dünndarmkarzinome und Pleuramesotheliom sowie die neuen ICD-O-Code-Nummern. Eine aktualisierte Kurzfassung der T- und N-Kategorien liegt in Form einer handlichen Broschüre bei.