According to AJCC staging guidelines, what should a clinician do when unsure between two stages?

When a clinician is unsure between two stages according to the AJCC staging guidelines, the appropriate course of action is to assign the lower (lesser) stage. This principle is rooted in the conservative approach to staging, which is intended to avoid overstaging a patient's disease. By assigning the lower stage, the clinician ensures that the patient's treatment plan is not based on potentially inaccurate information regarding the extent of their disease. This approach not only reflects a cautious strategy but also aligns with the general ethos of providing care that prioritizes patient safety and accurate assessment.

The rationale behind this guidance is to prevent unnecessary anxiety and possibly more aggressive treatment options that could arise from an incorrect assignment of a higher stage. Thus, when there is uncertainty, opting for the lower stage is seen as a more prudent and defensible decision in clinical practice.