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Staging of T2 and T3 nasopharyngeal carcinoma: Proposed modifications for improving the current AJCC staging system
- Source :
- Cancer Medicine, Cancer Medicine, Vol 9, Iss 20, Pp 7572-7579 (2020)
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Objectives We aimed to reconstitute T2 and T3 stage classification in nasopharyngeal carcinoma (NPC) cases and verify its utility in clinical settings. Materials and Methods We enrolled 792 NPC patients. Cox proportional hazards model was used to compare the effect sizes (hazard ratio [HR]) of the cranial structure invasion on survival and select the structures for up‐staging or downstaging T2 and T3 NPC. The samples were reclassified and the survival curves for T2 and T3 stages were analyzed. The proposed new staging system was validated on an external sample (n = 433). Results Thirteen cranial structures were examined. American Joint Committee on Cancer (AJCC) T3 stage patients with the invasion of the base of the sphenoid (HR = 2.58, 95% CI = 1.16‐5.77) or base of the pterygoid (HR = 2.00, 95% CI = 0.84‐4.77) had significantly lower hazard ratios than T2 stage patients with the invasion of soft tissues in the bilateral parapharyngeal space (HR = 5.26, 95% CI = 2.02‐13.68) and single/bilateral carotid sheath (HR = 7.78, 95% CI = 3.06‐19.76). T3 stage with the invasion of the above‐mentioned bones was reclassified as T2, and T2 stage with the invasion of the above‐mentioned soft‐tissue structures was reclassified as T3. Survival analysis showed a significant difference between the reclassified T2 and T3 stages (P<br />Hazard ratio was lower for AJCC T3 with bone than AJCC T2 with soft tissue invasion ·The 5‐year OS and PFS were higher for re‐classified T2 than T3 stage NPC patients·Modified staging system for T2 and T3 NPC may result in better management.
- Subjects :
- Adult
Male
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Biopsy
AJCC stage system
lcsh:RC254-282
survival analysis
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Parapharyngeal space
Humans
Neoplasm Invasiveness
Radiology, Nuclear Medicine and imaging
Stage (cooking)
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Original Research
AJCC staging system
Nasopharyngeal Carcinoma
Proportional hazards model
business.industry
Hazard ratio
Disease Management
Reproducibility of Results
Clinical Cancer Research
Cancer
Nasopharyngeal Neoplasms
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
medicine.disease
Combined Modality Therapy
Magnetic Resonance Imaging
Treatment Outcome
030104 developmental biology
Nasopharyngeal carcinoma
T staging
030220 oncology & carcinogenesis
MRI imaging
Female
business
Subjects
Details
- ISSN :
- 20457634
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Cancer Medicine
- Accession number :
- edsair.doi.dedup.....807269479a01fdfae368f62bc083b03a