title: Revision concepts and distinctive points of the new Japanese classification for biliary tract cancers in comparison with the 7(th) edition of the Union for International Cancer Control and the American Joint Committee on Cancer staging system.
abstract: BACKGROUND
  The 3(rd) English edition of the Japanese classification of the biliary tract cancers (JC) is now available in this journal. The primary aim of this revision is to provide all clinicians and researchers with a common language of cancer staging at an international level. On the other hand, there are several important issues that should be solved for the optimization of the staging system.
  
  
  METHODS
  Revision concepts and major revision points of the 3(rd) English edition of the JC were reviewed. Furthermore, comparing with the 7(th) edition of staging system developed by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC), distinctive points in the JC was discussed.
  
  
  RESULTS
  In this edition of the JC, the same stage groupings as those in the UICC/AJCC staging system were basically adopted. T, N, and M categories were also identical in principle with those in the UICC/AJCC staging system, although slight modifications were proposed as the "Japanese rules". As distinctive points, perihilar cholangiocarcinomas and ampullary region carcinomas were clearly defined. Intraepithelial tumor was discriminated from invasive carcinoma at ductal resection margins. Classifications of site-specific surgical margin status remained in this edition. Histological classification was based on that in the former editions of the JC, but adopted some parts of the World Health Organization classification.
  
  
  CONCLUSIONS
  The JC now share its staging system of the biliary tact carcinomas with the UICC/AJCC staging system. Future validation of the "Japanese rules" could provide important evidence to make globally standardized staging system.
authors.affiliation: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyakawa
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D001650:Bile Duct Neoplasms / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D007391:International Cooperation; D007564:Japan; D009367:Neoplasm Staging; D014481:United States
keywords: Biliary tract cancers; Japanese classification; Staging system; UICC/AJCC staging system