TEOC Oncologia Clínica key terms

Abnormal, purposeless proliferation of cells that persists after the stimulus that triggered it has ceased, producing a mass of tissue whose growth is not coordinated with normal tissue needs.

Disordered but non-invasive cellular growth in which cells lose normal orientation and maturation, showing nuclear atypia and mitoses; graded as low or high, it is a precursor lesion rather than cancer.

High-grade neoplastic change confined by the basement membrane, with full-thickness epithelial atypia but no stromal invasion; it lacks metastatic potential yet warrants local treatment or close surveillance.

Spread of malignant cells from a primary tumour to a distant site through lymphatics, blood, or body cavities, where they implant and grow as secondary deposits that define advanced disease.

Presence of tumour cells inside lymphatic or blood vessel spaces, seen on histology; it signals higher risk of nodal or distant spread and often influences decisions about adjuvant therapy.

Semiquantitative score of how closely tumour cells resemble their normal counterpart, based on differentiation, nuclear atypia and mitotic activity; higher grade generally predicts more aggressive behaviour.

Degree to which neoplastic cells retain the structural and functional features of the tissue of origin; well-differentiated tumours resemble normal tissue, whereas poorly differentiated ones are hard to classify.

Anatomical staging system describing extent of the primary tumour (T), regional lymph nodes (N) and distant metastases (M); combined stages group patients for prognosis and treatment selection.

First lymph node draining a tumour, identified by dye or radiotracer; if histologically negative it predicts the rest of the nodal basin is clear, allowing selective rather than routine lymphadenectomy.

Patient or tumour characteristics measured at diagnosis that predict outcome independent of treatment, such as stage, grade, performance status and biomarkers; they guide therapy intensity and follow-up.

Biomarkers that forecast the likelihood of benefit from a specific therapy, such as hormone receptor status for endocrine treatment or HER2 amplification for trastuzumab; they differ from purely prognostic factors.

Technique using labelled antibodies to detect specific proteins in tissue sections, helping to confirm histogenesis, distinguish primary from metastatic tumours, and assess predictive markers such as hormone receptors.

Histologically confirmed metastatic malignancy whose primary site cannot be identified after history, examination, imaging and basic pathology; managed with immunohistochemistry-guided, often empiric, systemic therapy.

Clinical or biochemical abnormality caused by substances secreted by a tumour or by immune cross-reactivity, remote from the tumour and its metastases, such as hypercalcaemia or SIADH.

Elevated serum calcium in cancer, usually from parathyroid hormone-related peptide secretion by solid tumours or from osteolytic bone metastases; causes confusion, dehydration and arrhythmia and requires urgent hydration.

Obstruction of superior vena cava flow, typically by mediastinal tumour or thrombosis, producing facial swelling, distended neck veins and dyspnoea; a vascular oncologic emergency needing prompt assessment.

Absolute neutrophil count below 500 per microlitre (or expected to fall below) together with fever of 38.3 °C once or 38.0 °C sustained, requiring urgent cultures and empirical broad-spectrum antibiotics.

Lowest blood cell count reached after cytotoxic chemotherapy, usually 7 to 14 days after administration, marking the period of greatest infection and bleeding risk before recovery.

Gastrointestinal toxicity triggered by cytotoxic drugs through serotonin and substance P pathways, classified as acute, delayed or anticipatory; prevented with 5-HT3 antagonists, NK1 antagonists and dexamethasone.

Painful inflammation and ulceration of oral mucosa after chemotherapy or head and neck radiation, impairing intake and predisposing to infection; managed with oral hygiene, analgesia and nutritional support.

Chemotherapy-induced fall in neutrophils, platelets or haemoglobin causing infection, bleeding or anaemia; graded by severity and managed with dose adjustment, transfusion or growth factor support.

Recombinant growth factor such as filgrastim that stimulates neutrophil production, used to prevent or treat chemotherapy-induced neutropenia and to enable dose-dense regimens.

Performance status scale from 0 to 100 percent describing a patient's ability to carry out normal activities and self-care; lower scores predict poorer tolerance of intensive treatment and shorter survival.

Six-point scale from 0 (fully active) to 5 (dead) summarising how much a patient's disease limits daily activity; used to select treatment intensity and eligibility for clinical trials.

Disappearance of all measurable tumour lesions and, where relevant, normalisation of tumour markers on imaging assessment; a favourable endpoint in trials and a goal of curative-intent therapy.

Reduction in the sum of target lesion diameters meeting a predefined threshold, usually at least 30 percent, without appearance of new lesions or progression of non-target disease.

Standardised imaging criteria defining measurable disease, target and non-target lesions, and categories of complete response, partial response, stable disease and progression for solid tumours in trials.

Tumour lesion that can be accurately measured in at least one dimension by imaging, with a minimum size threshold; only measurable lesions count toward response assessment in trial criteria.

Time from a defined starting point, usually diagnosis or randomisation, until death from any cause; the most robust and patient-relevant efficacy endpoint in oncology trials.

Time from treatment start or randomisation until documented tumour progression or death, whichever comes first; a common trial endpoint that is reached earlier than overall survival.

Prospective study in which participants are assigned by chance to intervention or control groups, minimising selection bias and providing the strongest evidence for treatment efficacy.

Clinical decision-making that integrates the best available research evidence, clinician expertise and patient values; in oncology it underpins guideline-concordant treatment selection.

Systematically developed recommendations that assist decisions about care for specific clinical circumstances, usually synthesising evidence and expert consensus for a defined tumour type or scenario.

Resection of a tumour with adequate margins and, when indicated, regional lymph node dissection; curative for localised disease and also used for palliation or debulking in advanced disease.

Distance between tumour and the cut edge of the resected specimen; a negative (R0) margin means no tumour cells at the edge, while R1 and R2 indicate microscopic and macroscopic residual disease.

Use of ionising radiation to damage tumour DNA and control local disease; delivered externally or by brachytherapy, with curative, adjuvant or palliative intent depending on the clinical setting.

Radiation given after definitive surgery to eliminate microscopic residual disease and reduce local recurrence, for example after breast-conserving surgery or resection of high-risk rectal cancer.

Radiotherapy delivered with the aim of relieving symptoms such as pain from bone metastases, bleeding, or obstruction, using short courses and low cumulative doses to minimise burden.

Systemic cytotoxic treatment given after complete surgical resection of a tumour when occult micrometastases are likely, aiming to reduce recurrence risk and improve survival.

Systemic treatment given before planned surgery or radiation to shrink a tumour, improve resectability or organ preservation, and test in vivo tumour sensitivity to the chosen drugs.

Anticancer drugs that inhibit specific molecular targets driving tumour growth, such as tyrosine kinases or mutated signalling proteins, selected by biomarker testing and generally less myelosuppressive than chemotherapy.

Treatment that harnesses the immune system against cancer, chiefly immune checkpoint inhibitors such as anti-PD-1 or anti-CTLA-4 antibodies, which can produce durable responses and immune-related toxicity.

Organ inflammation caused by checkpoint inhibitor therapy, affecting skin, gut, thyroid, liver or lungs; managed by grading severity and using corticosteroids or other immunosuppression when significant.

Oestrogen or progesterone receptor protein expressed by breast cancer cells, detected by immunohistochemistry and predicting benefit from endocrine therapy such as tamoxifen or aromatase inhibitors.

Multidisciplinary care focused on relieving pain, symptoms and psychosocial distress and improving quality of life for patients with serious illness, delivered alongside disease-directed treatment when appropriate.

Stepwise use of non-opioid and opioid analgesics, co-analgesics and interventional techniques to control cancer pain, following the analgesic ladder and treating breakthrough pain separately.