The 7th edition AJCC staging system for eye cancer: an international language for ophthalmic oncology.

Abstract

T Ophthalmic Oncology Task Force1 has significantly changed the American Joint Committee on Cancer (AJCC) staging system for eye cancer. The 7th edition incorporates more clinically relevant, site-specific staging systems for primary cancers of the eyelids, eye, and orbit.2 All chapters now include detailed clinical and pathology guidelines for data acquisition and tissue processing, while collecting evidence-based biomarkers and prospective data points. In 2004, pairs of clinical and pathology specialists were assigned to review each of the 6th edition AJCC chapters for their clinical, pathology, and research utility. Each pair was charged with creating a new, evidence-based medical foundation for its staging systems. They were required to seek biomarkers (known risk factors) and up to 6 data points for evaluation as potential ‘‘future’’ biomarkers. Their initial drafts were reviewed by a second clinician and pathologist team of reviewers. Their comments and suggestions were discussed during periodic subcommittee teleconferences and face-to-face meetings. Then, each section was subjected to review by multiple additional specialists. During this 4-year process, the Ophthalmic Oncology Task Force grew to include 45 eye cancer specialists from 10 countries (including 3 official International Union Against Cancer [UICC; L’Union Internationale Contre le Cancer] representatives) who worked together to define a comprehensive, anatomically based TNM (tumornode-metastasis)–based staging system for eye cancer. This peer-review system allowed for an evaluation, synthesis, and consensus for clinical practice parameters and pathology techniques and review. The following AJCC chapters are reviewed in 3 different papers published in this joint issue for ophthalmic pathology between the Archives of Pathology & Laboratory Medicine and the Archives of Ophthalmology.