*Sanjoy Sanyal
Sunday, Sept 30, 2012: 11:25 PM – 12:25 PM – LK Lower Lobby
← Back to Medicine X 2012 Proceedings
*Presenting Speaker


In the Union for Cancer Control (UICC) TNM classification, Tumor status (T) is given by Arabic numerals (T1, T2 etc). Lymph node status (N) is designated as N0, N1 etc. Distant metastases (M) are designated as M0 (absent) and M1 (present). These three parameters are grouped to give the clinical Stage of tumor, designated by Roman numeral I, II etc. For many tumors one or more Stages are subdivided into ‘a’ and ‘b’. The permutations and combinations of T, N, and M within a particular Stage varies among tumors from different regions. Tumor Stages may have 24 or more possible combinations of T, N and M. Given the T, N, M status for a particular patient, this complex classification renders it difficult for the oncologist to quickly determine the Stage of tumor without the aid of a TNM chart.

Presenting the Excel™-based e-Staging tool

An interactive Excel-based e-Staging tool designed by the author is being presented that provides an automatic method to quickly establish the Stage of Breast, Lung, Colon, Rectal, Cervical and Prostate cancers and Melanoma, with four mouse-clicks, based on the T, N, and M status categories fed into the system by the physician.

Technological features demonstrated

The tumor e-Staging tool has been rendered on Excel webpage (.mht) format. The first page of the tool will give the physician the option to select the particular tumor whose Staging is under consideration. Once on that tumor page, the physician will be asked to select successively the appropriate T, N and M status of that tumor. It will take the physician seamlessly through the three steps. The final page will give the Clinical Stage of that tumor in the patient.

Novel aspects of design and function

This interactive e-Staging tool is much simpler and easier to use than StageCRAFT© and AJCC e-Staging tool from American Joint Committee on Cancer. It is in Excel Webpage (.mht) format that can be created and used by any physician, even with minimum computer skills. It is a semi-automatic process, requiring only four mouse clicks from the physician. The process is very quick for the busy physician, taking just a few seconds to arrive at the Clinical Stage of the tumor. It eliminates the need to consult complicated TNM charts, which are different for every tumor. It eliminates the need to rely on memory, thus reducing the chances of error and inconsistency between physicians. The tool can be implemented in a busy physician’s PDA or incorporated in a hospital EMR system with HL7. It is scalable, with options to add more tumor sites to the system.

More information about project

The UICC announced its 7th Edition of TNM classification of Tumors in May 2011, introducing several significant differences from its 6th Edition. The details can be found at  http://www.uicc.org/tnm. Details of other more complicated e-Staging tools can be found at http://www.tumourstager.com/ and on AJCC website (https://www.ajcce-staging.com/staging/access/demoFwd)


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