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Article: The strength/weakness of the AJCC/UICC staging system (7th edition) for nasopharyngeal cancer and suggestions for future improvement

TitleThe strength/weakness of the AJCC/UICC staging system (7th edition) for nasopharyngeal cancer and suggestions for future improvement
Authors
KeywordsNasopharyngeal Cancer
Prognostication
Staging System
Issue Date2012
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology
Citation
Oral Oncology, 2012, v. 48 n. 10, p. 1007-1013 How to Cite?
AbstractBackground and purpose: To evaluate the current AJCC/UICC staging system (7th edition) for nasopharyngeal carcinoma and to explore for future improvement. Materials and methods: A total of 985 patients, initially staged with preceding 5-6th edition, were retrospectively re-staged with the 7th edition. All were assessed by magnetic resonance imaging, and all 945 non-disseminated patients were irradiated with conformal/intensity-modulated technique. Results: Staging factors by both the 5-6th edition and the 7th edition were strongly significance for important endpoints (p < 0.001). Down-staging of the previous T2a to T1 and, stages IIA to I in the 7th edition was appropriate. However, the impacts on overall stage distribution and prognostication were minimal. Further down-staging of the current T2 to T1, N2 to N1, stages II to I, and merging of N3a and N3b, stages IVA and IVB were suggested. With the 7th edition, the 5-year disease-specific survival (DSS) was 100% for stage I, 95% for II, 90% for III, 67% for IVA, 68% for IVB and 18% for IVC. The corresponding DSS for the proposed stages I, II, III and IV were 95%, 86%, 67% and 18%, respectively. Conclusions: The changes introduced in the 7th edition were appropriate, but the magnitude of improvement was minimal. With improving results by modern management, further simplification of the staging system is suggested. The proposed system could lead to more accurate prognostication, further validation is warranted. © 2012 Elsevier Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/180453
ISSN
2015 Impact Factor: 4.286
2015 SCImago Journal Rankings: 1.764
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, AWMen_US
dc.contributor.authorNg, WTen_US
dc.contributor.authorChan, LKen_US
dc.contributor.authorChan, OSHen_US
dc.contributor.authorHung, WMen_US
dc.contributor.authorChan, CCen_US
dc.contributor.authorCheng, PTCen_US
dc.contributor.authorSze, Hen_US
dc.contributor.authorLam, TSen_US
dc.contributor.authorYau, TKen_US
dc.date.accessioned2013-01-28T01:38:15Z-
dc.date.available2013-01-28T01:38:15Z-
dc.date.issued2012en_US
dc.identifier.citationOral Oncology, 2012, v. 48 n. 10, p. 1007-1013en_US
dc.identifier.issn1368-8375en_US
dc.identifier.urihttp://hdl.handle.net/10722/180453-
dc.description.abstractBackground and purpose: To evaluate the current AJCC/UICC staging system (7th edition) for nasopharyngeal carcinoma and to explore for future improvement. Materials and methods: A total of 985 patients, initially staged with preceding 5-6th edition, were retrospectively re-staged with the 7th edition. All were assessed by magnetic resonance imaging, and all 945 non-disseminated patients were irradiated with conformal/intensity-modulated technique. Results: Staging factors by both the 5-6th edition and the 7th edition were strongly significance for important endpoints (p < 0.001). Down-staging of the previous T2a to T1 and, stages IIA to I in the 7th edition was appropriate. However, the impacts on overall stage distribution and prognostication were minimal. Further down-staging of the current T2 to T1, N2 to N1, stages II to I, and merging of N3a and N3b, stages IVA and IVB were suggested. With the 7th edition, the 5-year disease-specific survival (DSS) was 100% for stage I, 95% for II, 90% for III, 67% for IVA, 68% for IVB and 18% for IVC. The corresponding DSS for the proposed stages I, II, III and IV were 95%, 86%, 67% and 18%, respectively. Conclusions: The changes introduced in the 7th edition were appropriate, but the magnitude of improvement was minimal. With improving results by modern management, further simplification of the staging system is suggested. The proposed system could lead to more accurate prognostication, further validation is warranted. © 2012 Elsevier Ltd. All rights reserved.en_US
dc.languageengen_US
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncologyen_US
dc.relation.ispartofOral Oncologyen_US
dc.subjectNasopharyngeal Canceren_US
dc.subjectPrognosticationen_US
dc.subjectStaging Systemen_US
dc.titleThe strength/weakness of the AJCC/UICC staging system (7th edition) for nasopharyngeal cancer and suggestions for future improvementen_US
dc.typeArticleen_US
dc.identifier.emailSze, H: henrysze@graduate.hku.hken_US
dc.identifier.authoritySze, H=rp01697en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.oraloncology.2012.03.022en_US
dc.identifier.pmid22525607-
dc.identifier.scopuseid_2-s2.0-84866414936en_US
dc.identifier.hkuros219064-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84866414936&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume48en_US
dc.identifier.issue10en_US
dc.identifier.spage1007en_US
dc.identifier.epage1013en_US
dc.identifier.isiWOS:000309114600019-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridLee, AWM=17035384900en_US
dc.identifier.scopusauthoridNg, WT=14825781500en_US
dc.identifier.scopusauthoridChan, LK=55068223300en_US
dc.identifier.scopusauthoridChan, OSH=37033537400en_US
dc.identifier.scopusauthoridHung, WM=7201803700en_US
dc.identifier.scopusauthoridChan, CC=27170059100en_US
dc.identifier.scopusauthoridCheng, PTC=23968519000en_US
dc.identifier.scopusauthoridSze, H=23490726900en_US
dc.identifier.scopusauthoridLam, TS=55189731600en_US
dc.identifier.scopusauthoridYau, TK=24068258100en_US

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