The ORC Patient/Tumor Classification—A New Approach: A New Challenge with Special Consideration for the Lung

Abstract

Purpose: The development of malignancy is a life changing concern for many individuals. The classification of the tumor alone does not adequately take into consideration the patient’s physical condition. Thus, a system to classify both the patient and the tumor has been followed-the ORC system. Method: Additional information regarding the patient and their health has been followed by most physicians but not systematically categorized. By using the individuals health information in addition to the TNM classification one can more adequately advise the patient. Thus O-operability, R-resectability, and C-curability are all considered and more appropriately define the patient and his/her tumor condition. Results: The patient’s physical condition must be acceptable for the treatment-whether surgical or nonsurgical. Pulmonary, cardiac, muscular, renal or other disease entities must not be so severe as to prevent treatment (operability). The lesion should be in a location and of a size to afford possible excision-resectability, and the tumor should be potentially curable in order to justify major intervention. Thus, by combining the patient’s specific health status as well as the tumor characteristics (TNM) a better clarification of the treatment, the options, and the prognosis are delineated. Conclusion: When a patient is seen with a tumor-malignant or benign, therapeutic considerations must include the individual’s health status as well as the tumor prior to determining the treatment. Therefore, a system to consider both the health and the tumor is proposed-the ORC system.