RECENT ADVANCES IN T.N.M.

Abstract

It was Professor P. F. Denoix, of Paris, who first thought of the T.N.M. system, which is, in effect, a sort of shorthand notation for describing the extent of the primary tumour (T), the state of the regional lymph nodes (N), and the presence or absence of distant m?tastases (M). The idea germinated between 1943 and 1952, and several papers were published by Denoix in the Bulletin de VInstitut National d'Hygi?ne.1'3 The first time that the T.N.M. system can be said to have impinged on the international conscience was at the Radiological Congress in Copenhagen in 1953 and at the seventh Congress of the U.I.C.C. in Brazil in 1954. The sites which were thought most suitable for staging were the breast and the larynx. In the ensuing years a great deal of work was done in Great Britain on staging the breast. The Association of Surgeons and the Faculty of Radiologists set up a joint committee to make recommendations, and between 1955 and 1958 this committee met on numerous occasions and its findings were reviewed in the British Medical Journal.41 These suggestions, after modification, were accepted by the Eighth International Congress held in London later in 1958, and a five-year trial period of the breast classification came into operation on 1 January I960.5 This period finishes at the end of 1964, and it will then be the duty of the staging committee to consider criticisms of the classification before submitting definitive proposals to the World Health Organization. Two other brochures have been published by the U.I.C.C. concerning the T.N.M. classification of tumours of the bladder, mouth, and upper air-passages,6 7 and these also will have five year periods for assessment.