Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved..
The AJCC/UICC TNM classification describes anatomic extent of tumor progression and guides treatment decisions. Our comprehensive analysis of 8,834 newly diagnosed patients with non-metastatic Epstein-Barr virus related nasopharyngeal carcinoma (NPC) from six Chinese centers indicates certain limitations in the current staging system. The 8th edition of the AJCC/UICC TNM classification inadequately differentiates patient outcomes, particularly between T2 and T3 categories and within the N classification. We propose reclassifying cases of T3 NPC with early skull-base invasion as T2, and elevating N1-N2 cases with grade 3 image-identified extranodal extension (ENE) to N3. Additionally, we suggest combining T2N0 with T1N0 into a single stage IA. For de novo metastatic (M1) NPC, we propose subdivisions of M1a, defined by 1-3 metastatic lesions without liver involvement, and M1b, characterized by >3 metastatic lesions or liver involvement. This proposal better reflects responses of NPC patients to the up-to-date treatments and their evolving risk profiles.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Cancer cell - 42(2024), 3 vom: 11. März, Seite 464-473.e3 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Du, Xiao-Jing [VerfasserIn] |
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| Links: |
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| Themen: |
Early skull-base invasion |
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| Anmerkungen: |
Date Completed 14.03.2024 Date Revised 14.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ccell.2023.12.020 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a The AJCC/UICC TNM classification describes anatomic extent of tumor progression and guides treatment decisions. Our comprehensive analysis of 8,834 newly diagnosed patients with non-metastatic Epstein-Barr virus related nasopharyngeal carcinoma (NPC) from six Chinese centers indicates certain limitations in the current staging system. The 8th edition of the AJCC/UICC TNM classification inadequately differentiates patient outcomes, particularly between T2 and T3 categories and within the N classification. We propose reclassifying cases of T3 NPC with early skull-base invasion as T2, and elevating N1-N2 cases with grade 3 image-identified extranodal extension (ENE) to N3. Additionally, we suggest combining T2N0 with T1N0 into a single stage IA. For de novo metastatic (M1) NPC, we propose subdivisions of M1a, defined by 1-3 metastatic lesions without liver involvement, and M1b, characterized by >3 metastatic lesions or liver involvement. This proposal better reflects responses of NPC patients to the up-to-date treatments and their evolving risk profiles | ||
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| 700 | 1 | |a Wang, Gao-Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Xiao-Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Ya-Qian |e verfasserin |4 aut | |
| 700 | 1 | |a Lei, Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Liang-Fang |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Kun-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Yan-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Ling-Long |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Ling |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Zheng |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Gui-Qiong |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Qin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xu |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Guan-Qun |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Wen-Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yu-Pei |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Fo-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Xiao-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Si-Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Shu-Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Cui, Chun-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Ji-Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Ren, Jian |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ming-Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Li-Zhi |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Jun |e verfasserin |4 aut | |
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