Cancer staging: future directions for the TNM classification

Bench to bedside and back again: molecular mechanisms of alpha-catenin function and roles in tumorigenesis

The cadherin/catenin complex, comprised of E-cadherin, beta-catenin and alpha-catenin, is essential for initiating cell-cell adhesion, establishing cellular polarity and maintaining tissue organization. Disruption or loss of the cadherin/catenin complex is common in cancer. As the primary cell-cell adhesion protein in epithelial cells, E-cadherin has long been studied in cancer progression. Similarly, additional roles for beta-catenin in the Wnt signaling pathway has led to many studies of the role of beta-catenin in cancer. Alpha-catenin, in contrast, has received less attention. However, recent data demonstrate novel functions for alpha-catenin in regulating the actin cytoskeleton and cell-cell adhesion, which when perturbed could contribute to cancer progression. In this review, we use cancer data to evaluate molecular models of alpha-catenin function, from the canonical role of alpha-catenin in cell-cell adhesion to non-canonical roles identified following conditional alpha-catenin deletion. This analysis identifies alpha-catenin as a prognostic factor in cancer progression.

Quality of life after treatment for laryngeal carcinomas

The objective of this study was to evaluate the impact of different surgical treatments as well as of radiotherapy for laryngeal carcinomas on health-related quality of life (QL). In a prospective, randomized multicenter study (five university hospitals in Germany), a total of 146 patients with laryngeal carcinomas (UICC stages: I-IV) underwent different surgical treatments (32 total laryngectomies, 81 CO(2) laser microsurgical partial laryngectomies, 33 open partial laryngectomies). Postoperative radiotherapy was performed in 44 patients. QL data were obtained by using the EORTC QLQ-C30 questionnaire (developed by the European Organization for Research and Treatment of Cancer). Impaired QL data were seen after total laryngectomy and after radiotherapy. Radiotherapy seemed to have more impact on QL than surgical treatment. Global QL was not affected by any treatment. In general, the QL data were not as discriminating as presumed. To evaluate coping abilities, objective measures (voice, swallowing, breathing) should be obtained for comparison in further investigations.

The National Cancer Data Base report on trends in cancer patient staging

BACKGROUND

Previous Commission on Cancer studies have examined trends in the staging of cancer patients. Reported herein are the most current National Cancer Data Base (NCDB) data on staging.

METHODS

Two "calls for data" have yielded a total of 770,100 reports of patients with cancer eligible for staging.

RESULTS

For all stageable sites combined, the percentage of cases with documentation of staging increased from 1985 through 1990 (53% in 1985 vs. 77% in 1990). Cancers of the colon and breast were staged most frequently. Of the 837 NCDB-participating hospitals, 557 (67%) staged 80% or more of the patients with cancer.

CONCLUSIONS

These results suggest that the frequency of staging is a function of hospitals rather than physicians or types of patients. Many interrelated factors contributed to the increase in the frequency of staging.