Disease-specific staging and risk systems (FIGO, Ann Arbor, IPI, R-ISS, ELN, IMDC)
Beyond the generic TNM system, many cancers have their own way of sorting patients into risk groups, using stage, blood tests, genetics and fitness together. The name on the report (FIGO, IPI, ELN, IMDC) tells you which rulebook is being used.
FIGO stages gynaecological cancers (with the 2023 endometrial revision adding molecular class). Ann Arbor/Lugano stages lymphoma and the IPI adds age, LDH, performance status and extranodal sites; R-ISS and R2-ISS combine stage, LDH and cytogenetics in myeloma; ELN 2022 assigns AML to favourable, intermediate or adverse genetic risk that decides transplant; IMDC (Heng) criteria stratify metastatic kidney cancer and select immunotherapy doublets; INRG and COG groups stratify neuroblastoma; Rai and Binet stage CLL. Each maps to a treatment intensity, is the basis of trial eligibility and stratification, and is periodically revised as new markers (ctDNA, MRD, gene expression) prove more predictive.