Shouptik Basu, Consultant Surgical Oncologist at Saroj Gupta Cancer Centre and Research Institute, shared about 6th Global Cancer Consortium (GCC) Conference 2026, adding:
“At the 6th Global Cancer Consortium (GCC) Conference 2026, held in conjunction with the 15th East Zonal Oncology Symposium (EZOS) in Kolkata, India, I had the privilege of participating in a debate on an important and highly relevant topic in contemporary oncology:
‘Is anatomical staging obsolete in the era of precision oncology?’
I spoke in favour of the motion, with Dr. Animesh Saha, Senior Radiation Oncologist from Apollo Hospitals, Kolkata, presenting the counterview. The session was expertly moderated by Dr. Prasenjit Chatterjee, Senior Clinical Oncologist at Manipal Hospitals, and chaired by two senior surgeons and respected senior teachers, in Surgery Prof. Makhan Lal Saha and Dr. Aditya Narayan Sen.
During the debate, I attempted to present a holistic view of contemporary cancer care—one that extends beyond staging alone. My focus was on practical, real-world considerations such as effective financial planning, comprehensive cancer management, aligning patient expectations with clinical realities, and simplifying research work from a clinician’s perspective.
What followed was a spirited, engaging, and thoroughly enjoyable academic exchange. I was both happy and humbled that, at the conclusion of the session, the audience voted in favor of the motion.
My central argument was straightforward: anatomical staging is not obsolete—it remains the foundation upon which precision oncology operates.
Anatomical Staging: The Universal Language of Oncology
From the early work of Dukes and Denoix to modern multidisciplinary tumor boards, anatomical staging has remained the universal language of oncology. Across institutions and subspecialties, the first question in any MDT discussion continues to be:
‘What is the stage?’
Precision oncology has not replaced this question—it depends on it.
Precision Oncology: The Cherry on Top, Not the Base
Precision oncology represents a significant advance, but it functions within the framework of anatomical staging. An actionable molecular alteration may exist, but disease location and stage determine clinical intent—whether cure, long-term control, or palliation is achievable.
Biology may be king, but anatomy guides biology, and gives it clinical context.
Stage First, Target Later: Clinical Reality
Even in current practice:
Early-stage cancers achieving pathological complete response still require anatomical and surgical assessment.
In lung, breast, and gastrointestinal cancers, adjuvant systemic therapy is guided primarily by stage, even when molecular data are available.
Pathological complete response itself remains a histological and anatomical endpoint.
Targeted therapy follows staging; it does not precede it.
Limited Integration of Molecular Data into Staging
Despite advances in molecular diagnostics, most staging systems remain predominantly anatomical. Molecular and genetic classifications have been incorporated only minimally, and prognostic survival estimates continue to rely largely on stage rather than molecular biomarkers. The biggest example includes the recent ESGO–ESTRO–ESP guidelines for the management of patients with endometrial carcinoma: update 2025 published in Lancet
The Practical Lens: Affordability and Access
Precision oncology carries substantial cost implications—NGS, ctDNA, immunotherapy, CAR-T cells, and genetic testing are not universally accessible. For many patients, particularly in resource-limited settings, anatomical staging remains the most practical, affordable, and actionable clinical tool.
Final Reflection
Precision medicine is powerful, but patients present with symptoms, disease burden, and expectations that must be aligned with clinical reality.
Precision oncology does not operate instead of staging—it operates within it.
That was the essence of my argument, and I am grateful for the opportunity to engage in such an important academic discussion on a platform that fostered rigorous debate and thoughtful exchange.
The motion was carried and a hall full of clinicians, scientists, oncologists, molecular biologists raised their hands in unison for the anatomical staging.”
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