E staging Tool for Tumors - Sanjoy Sanyal


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Computer program created by Dr Sanjoy Sanyal, Professor and Course Director of Neuroscience in the Caribbean. Paper was presented at Stanford Medicine X Conference in September 2012, Stanford University School of Medicine, CA. Patent Pending with USPTO January 2013.
Cancer e-Staging Standalone Program• A multi-step process was used to create the e- Staging Program.• It has 5 electronic pages, requiring 4 mouse clicks• Content page of the e-Staging tool gives a list of 26 cancers.• Once on any Tumor page, the physician is asked to successively select the appropriate T, N, M status of that cancer.• It takes the physician seamlessly through the 3 steps.• Final page gives cancer Stage.

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E staging Tool for Tumors - Sanjoy Sanyal

  1. 1. An Excel™-based e-Staging Tool for Tumors Dr. Sanjoy Sanyal MBBS, MS (Surgery), MSc (Royal College of Surgeons, Edinburgh), ADPHA Professor and Course Director, Medical University of the Americas, West IndiesAbstractGiven the extreme complexity of grouping the T, N, M status of a tumor into its Stages, it isimpossible to determine the Anatomical Stage Grouping of any tumor without the aid of complexTNM charts created by UICC. In order to render the process time- and user-friendly for thephysician, an Excel-based e-Staging tool was created for 26 tumors of the human body. With just 4mouse clicks one can arrive at the Stage of the tumor. This is a standalone tool, not requiring Internetconnection, and can be used in a handheld device in any hospital or clinic.IntroductionIn the Union for International Cancer Control (UICC) TNM classification, Tumor status (T) isdesignated as T1, T2 etc, regional lymph Node metastases (N) are designated as N0, N1 etc, anddistant Metastases (M) are designated as M0, M1. For some tumors, like Seminoma of testis, Serumtumor marker (S) is an additional parameter. Each parameter may be further subdivided into a, betc. The three (or four) major parameters are grouped in increasing stages of cancer to give theAnatomical Stage Grouping of the tumor, designated by Roman numeral I, II etc. For many tumorsthe Stages may be subdivided into A, B.Materials & MethodsStep 1: Tabulating ‘T’, ‘N’, ‘M’ (and any other) categories and Stages of Tumor on a plain paper,with data from UICC 7th Edition websiteStep 2: Employing mathematical rules of Permutations and Combinations, determining all possiblecombinations of TN, TNM, TNMS (if applicable) for that tumorStep 3: Designating each combination to an Excel worksheet, with appropriate Worksheet nameStep 4: Designating all stages of the tumor to separate Excel sheetsStep 5: Book-marking and Hyper-linking the T sheet with TN sheets, then to TNM sheets and finallyto each tumor Stage sheet in the fileStep 6: Repeating the process for 26 tumors of the human body on the same Excel WorkbookStep 7: Hyper-linking each tumor Worksheet to a Contents page on the same Excel Workbook (file)Step 8: Inserting illustrations and converting the file into .mht formatResultsContent page of the e-Staging tool gives a list of 26 tumors. Once on any Tumor page, the physicianis asked to successively select the appropriate T, N, M status of that tumor. It takes the physicianseamlessly through the 3 steps. Final page gives tumor Stage.Content page: 1st click
  2. 2. T page: 2nd clickN page: 3rd clickM page: 4th click
  3. 3. Stage page: FinalDiscussionThe permutations and combinations of T, N, M (and S) within a particular Anatomical StageGrouping is extremely complex and varies considerably between different tumors. This complexclassification renders it difficult for the oncologist to quickly determine the Stage of tumor withoutthe aid of a TNM chart.This interactive e-Staging tool is standalone (in .mht format), simpler (requiring only 4 mouseclicks), quicker (just a few seconds) and easier than those from Stage CRAFT©, AJCC andMelanoma Center, which are all Web-based. It can be used by any physician with minimumcomputer skills. It is portable, can be used in any hand-held device anywhere in the hospital or clinic,and does not require Internet connection. It eliminates consulting complicated TNM charts, whichare different for every tumor, and also the need to rely on memory, thus reducing errors andinconsistency between physicians. The tool can be incorporated in a hospital EMR with HL7. It isfuture-scalable, with options to add more tumor sites to the system.AcknowledgementsAssistance of Medical University of the Americas in preparing the poster is gratefully acknowledged.Authorship and Conference PresentationThis paper was authored by Dr Sanjoy Sanyal, Professor and Course Director of Neuroscience inMedical University of the Americas, Potworks, Charlestown, Nevis, St.Kitts-Nevis, West Indies. Itwas accepted at the international Stanford Medicine X Conference, and presented as a poster in
  4. 4. Stanford University School of Medicine, LKSC Conference Center, 291 Campus Drive, Stanford,California, CA 94305-5101, USA, on 30 September, 2012.Poster Screenshot CANCER E-STAGING STANDALONE PROGRAMProcess Flowchart for Implementation of Program
  5. 5. Implementation Step 1Implementation Step 2
  6. 6. Implementation Step 3Implementation Step 4
  7. 7. Implementation Step 5 PATENT STATUSProvisional Patent Application accepted by United States Patent and Trademark Office (USPTO),giving it a Patent Pending status.