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Paediatric Cancer Stage Guidelines

The IACR endorses the published Toronto Childhood Cancer Stage Guidelines and associated staging rules for use by population-based cancer registries.

Background

For many of the malignancies that occur in childhood, TNM-based systems that document extent of disease at diagnosis are either inadequate or do not exist at all. In addition, for some cancers, more than one system is in use. Consensus guidelines for use by population cancer registries for staging childhood cancers (the Toronto Childhood Cancer Stage Guidelines) have been developed to facilitate the collection of internationally consistent and comparable information on childhood cancer stage at diagnosis.

Toronto Paediatric Cancer Stage Guidelines
The Guidelines recommend the malignancy-specific staging system most suitable for use by population registries for 16 of the most common childhood malignancies. The Guidelines include a two-tiered approach that provides less detailed criteria for registries with limited resources and/or limited data access (Tier 1) and more detailed criteria for better-resourced registries (Tier 2). Tier 2 stage categories may be collapsed to Tier 1 categories to preserve comparability across registries.

The Australian Childhood Cancer Registry has had a leading role in the development and testing of rules for the collection of childhood cancer stage by cancer registries. In their website, they provide a staging manual (Childhood cancer staging for population registries according to the Toronto Childhood Cancer Stage Guidelines) that contains staging rules and detailed descriptions of the recommended staging systems, to assist population cancer registries to collect information on childhood cancer stage at diagnosis using source medical records (work supported through a national initiative by Cancer Australia as part of an approach to improving national cancer data on stage, treatment and recurrence).

The IACR endorses the published Toronto Childhood Cancer Stage Guidelines and associated staging rules for use by population-based cancer registries.

References:

The Guidelines and the consensus process by which they were developed is published in The Lancet Oncology 2016;17:e163-72.

Results of feasibility, validity and staging rules are published in The Lancet Child and Adolescent Health 2018; 2(3):173-179.  The staging manual "Childhood cancer staging for population registries according to the Toronto Childhood Cancer Stage Guidelines” is provided as an appendix to that publication.

A summary of the Guidelines is published in TNM Classification of Malignant Tumours, 8th edition (2017)

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