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which they occurred. It is important to verify that dates listed are accurate. Enclose copies of any documentation you have related to your complaint. Note: Please attach additional pages if necessary. Please also attach copies of ALL supporting documents, including purchase agreement, contracts receipts, cancelled checks, proof of vehicle insurance, registration, inspection reports, warranty documents, repair invoices or any other documents relating to your Region I Bureau of Field Operations, Region I 1135 Banks Road Margate, Florida 33063 Telephone = (954) 969-4216 FAX = (954) 969-4237 Responsible for Broward County Region II Bureau of Field Operations, Region II 318 Southeast 25th Avenue Ocala, Florida 34471 Telephone = (352) 732-1267 FAX = (352) 732-1459 Responsible for Alachua, Columbia, Gilchrist, Lake, Levy, Marion and Putnam Counties Region III Bureau of Field Operations, Region III 3200 Armsdale Road, Suite 13 Jacksonville, Florida 32218 Telephone = (904) 924-1524 FAX = (904) 924-1525 or 924-1530 Responsible for Baker, Bradford, Clay, Flagler, Duval, Nassau, St. Johns and Union Counties Region IV Bureau of Field Operations, Region IV 1354 South Woodland Boulevard Deland, Florida 32720 Telephone = (386) 736-5108 FAX = (386) 736-5112 Responsible for Brevard, Seminole and Volusia Counties Region V Bureau of Field Operations, Region V 4101 Clarcona-Ocoee Road, Suite 160 Orlando, Florida 32810 Telephone = (407) 445-7400 FAX = (407) 445-7411 Responsible for Orange and Osceola Counties Region VI Bureau of Field Operations, Region VI NET PARK, Suite 2228 5701 East Hillsborough Avenue Tampa, Florida 33610 Telephone = (813) 612-7110 FAX = (813) 612-7111 Responsible for Citrus, Hernando, Hillsborough, Pasco, Pinellas, Polk and Sumter Counties Updated 01-29-09complaint.
The extent or stage of cancer at the time of diagnosis is a key factor that deﬁnes prognosis and is a critical element in deter mining appropriate treatment based on the experience and outcomes of groups of prior patients with similar stage. In addition, accurate staging is necessary to evaluate the results of treatments and clinical trials, to facilitate the exchange and comparison of information among treatment centers, and to serve as a basis for clinical and translational cancer research. At a national and international level, the agreement on classi ﬁcations of cancer cases provides a method of clearly convey ing clinical experience to others without ambiguity. Several cancer staging systems are used worldwide. Dif ferences among these systems stem from the needs and objectives of users in clinical medicine and in population surveillance. The most clinically useful staging system is the tumor node metastasis (TNM) system maintained collabor atively by the American Joint Committee on Cancer (AJCC) and the International Union for Cancer Control (UICC). The TNM system classiﬁes cancers by the size and extent of the primary tumor (T), involvement of regional lymph node (N), and the presence or absence of distant metasta ses (M), supplemented in recent years by carefully selected nonanatomic prognostic factors. There is a TNM staging algorithm for cancers of virtually every anatomic site and histology, with the primary exception in this manual being staging of pediatric cancers.
Previous American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) stage groupings for esophageal cancer have not been data driven or harmonized with stomach cancer. At the request of the AJCC, worldwide data from 3 continents were assembled to develop data-driven, harmonized esophageal staging for the seventh edition of the AJCC/UICC cancer staging manuals. METHODS: All-cause mortality among 4627 patients with esophageal and esophagogastric junction cancer who underwent surgery alone (no preoperative or postoperative adjuvant therapy) was analyzed by using novel random forest methodology to produce stage groups for which survival was monotonically decreasing, distinctive, and homogeneous. RESULTS: For lymph node-negative pN0M0 cancers, risk-adjusted 5-year survival was dominated by pathologic tumor classification (pT) but was modulated by histopathologic cell type, histologic grade, and location. For lymph node-positive, pNþM0 cancers, the number of cancer-positive lymph nodes (a new pN classification) dominated survival. Resulting stage groupings departed from a simple, logical arrangement of TNM. Stage groupings for stage I and II adenocarcinoma were based on pT, pN, and histologic grade; and groupings for squamous cell carcinoma were based on pT, pN, histologic grade, and location. Stage III was similar for histopathologic cell types and was based only on pT and pN. Stage 0 and stage IV, by definition, were categorized as tumor in situ (Tis) (high-grade dysplasia) and pM1, respectively.
*Note: A tumor may penetrate the muscularis propria with extension into the gastrocolic or gastrohepatic ligaments, or into the greater or lesser omentum, without perforation of the visceral peritoneum covering these structures. In this case, the tumor is classified T3. If there is perforation of the visceral peritoneum covering the gastric ligaments or the omentum, the tumor should be classified T4. **The adjacent structures of the stomach include the spleen, transverse colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small intestine, and retroperitoneum. ***Intramural extension to the deodenum or esophagus is classified by the depth of the greatest invasion in any of these sites, including the stomach. Reprinted with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer Science and Business Media LLC, www.springer.com. Stomach. In: Edge SE, Byrd DR, Carducci MA, Compton CC, eds. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2010:117-126.