Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma,Cancer Cell

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Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma
Cancer Cell ( IF 50.3 ) Pub Date : 2024-01-18 , DOI: 10.1016/j.ccell.2023.12.020
Xiao-Jing Du , Gao-Yuan Wang , Xiao-Dong Zhu , Ya-Qian Han , Feng Lei , Liang-Fang Shen , Kun-Yu Yang , Lei Chen , Yan-Ping Mao , Ling-Long Tang , Ling Li , Zheng Wu , Gui-Qiong Xu , Qin Zhou , Jing Huang , Rui Guo , Yuan Zhang , Xu Liu , Guan-Qun Zhou , Wen-Fei Li , Cheng Xu , Li Lin , Yu-Pei Chen , Fo-Ping Chen , Xiao-Yu Liang , Si-Yuan Chen , Shu-Qi Li , Chun-Yan Cui , Ji-Bin Li , Jian Ren , Ming-Yuan Chen , Li-Zhi Liu , Ying Sun , Jun Ma

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 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.

更新日期：2024-01-18

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