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J Cancer 2017; 8(9):1665-1672. doi:10.7150/jca.19197 This issue Cite

Research Paper

Evaluation of 7th Edition of AJCC Staging System for Nasopharyngeal Carcinoma

YuFeng Ren^1*, Huizhi Qiu^2*, Yujie Yuan³, Jinning Ye³, Yunhong Tian², Bixiu Wen¹, Weijun Zhang², Qun Li^{4, 5✉}

1. Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R.China;
2. Department of Radiotherapy, cancer center of Guangzhou medical university, Guangzhou 510080, P.R.China;
3. Center of Gastrointestinal Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R.China;
4. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, P.R.China;
5. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, P. R. China.
* These authors contributed equally to this work.

✉ Corresponding author: Qun Li., M.D., Ph.D; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, P. R. China; Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, P.R.China. E-mail: liqunorg.cn More

Abstract

Purpose: To evaluate and improve the 7^th edition International Union against Cancer/American Joint Committee on Cancer staging system for nasopharyngeal carcinoma.

Methods: A retrospective review of the data from 905 patients with biopsy-proven non-disseminated nasopharyngeal carcinoma was performed. All the patients were examined by magnetic resonance imaging (MRI) and received radiotherapy.

Results: Satisfied distributions among the stages were observed in the 7^th edition staging systems. LRFS only differed in classifications betweenT1 and T3, T1 and T4 (P=0.022 and P=0.016, respectively). Significant differences were observed between patients without and with masticator space involvement for OS, DMFS and PFS (p<0.05). No statistically significant differences in LRFS were observed among different groups with anatomical masticator space involvement. The DMFS between N2 and N3b, N3a and N3b were lack of significance (P=0.060 and P=0.59). The T category and N category were independent prognostic factors for the major endpoints in the Cox multivariate regression analysis (P<0.01).

Conclusion: This study confirmed the prognostic value of the 7^th edition UICC/AJCC staging system, the revisions of the 7^th edition staging system are acceptable. However, our study also revealed limitations in the current staging system and suggested some potential modifications in future revision.

Keywords: Nasopharyngeal carcinoma, American Joint Committee on Cancer, Staging system, prognosis.

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