Ninth Version of the AJCC and UICC Nasopharyngeal Cancer TNM Staging Classification

作者：Jian-Ji Pan, Hai‐Qiang Mai, Wai Tong Ng, Chaosu Hu, Jingao Li, Xiaozhong Chen, James Chung Hang Chow, E. Wong, Victor Lee, Ling-Yu Ma, Qiaojuan Guo, Qin Liu, Lizhi Liu, Tingting Xu, Xiaochang Gong, Meng‐Yun Qiang, Kwok‐Hung Au, Tsz-Chim Liu, Chi‐Leung Chiang, Youping Xiao, Shao-Jun Lin, Yunbin Chen, Shanshan Guo, Charlene H. L. Wong, Lin-Quan Tang, Zhiyuan Xu, Yizhen Jia, Wen-Sa Peng, Liping Hu, Tianzhu Lu, Jiang Feng, Caineng Cao, Wei Xu, Jun Ma, Pierre Blanchard, Michelle Williams, Christine M. Glastonbury, Ann D. King, Snehal G. Patel, Raja R. Seethala, A. Dimitrios Colevas, Daiming Fan, Melvin L.K. Chua, Shao Hui Huang, Brian O’Sullivan, William M. Lydiatt, Anne W.M. Lee · 发表于：JAMA Oncology · 年份：2024 · DOI：10.1001/jamaoncol.2024.4354 · 被引用次数：111 · 研究领域：Head and Neck Cancer Studies、Head and Neck Surgical Oncology、Esophageal Cancer Research and Treatment

Importance: Accurate staging is a fundamental step in treating patients with nasopharyngeal carcinoma (NPC) worldwide; this is crucial not only for prognostication, but also for guiding treatment decisions. The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) system is the global language for clinicians, researchers, and cancer registries. Continual improvement that aligns with contemporary pattern of care is essential. Objective: To improve the prognostic accuracy and clinical applicability of the eighth edition (TNM-8) for NPC. Design, Setting, and Participants: This multicenter study analyzed patients with NPC with detailed tumor features during January 2014 and December 2015 and was reviewed by experienced radiologists. The data analysis was completed in December 2023. The findings were further confirmed with internal and external validation. Statistical analyses and clinical considerations were reviewed by the AJCC/UICC multidisciplinary head and neck panels and attained consensus. The recommendations were evaluated by the AJCC Evidence-Based Medicine Committee before final endorsement as the ninth version (TNM-9). Main Outcomes and Measures: The primary end point was overall survival. Adjusted hazard ratios of different subgroups were then assessed for confirmation of optimal stage grouping. Results: Of the 4914 patients analyzed, 1264 (25.7%) were female and 3650 (74.3%) were male; the median (SD) age w...