Advance on staging system of nasopharyngeal carcinoma
- VernacularTitle:鼻咽癌的TNM临床分期研究进展
- Author:
Jun MA
;
Yanping MAO
- Publication Type:Journal Article
- Keywords:
nasopharyngeal neoplasm;
magnetic resonance imaging (MRI);
prognosis;
tuomor stage;
radiotherapy
- From:China Oncology
2006;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
The deficiencies of the 6th International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) staging system of nasopharyngeal carcinoma (NPC) were included as follows: ①There is a lack of hazard discrimination between some T categories; ②The maximum dimension of lymph node was not an independentprognosis in NPC; ③The subsets defi ned by T and N classifi cations that make up a given group typically have different prognosis. The introduction of new types of therapeutic interventions or new technologies may require modifi cations of the classif ication and staging systems. Compared to computerized tomography (CT), magnetic resonance imaging (MRI) is superior to in the detection of early involvement such as paranasopharyngeal space, oropharynx, and retropharyngeal lymphatic metastasis, and demonstrate deep primary tumor infi ltration such as skull base, intracranial erosion more easily, so MRI should be optional method in T stage of NPC. Positron emission tomography/ computerized tomography (PET/CT) is superior to MRI in the detection of cervical lymph node metastasis and distant metastasis. With the development of diagnostic and therapeutic techniques revolutionized in NPC, staging systems should be modified. Research based on the data of 924 NPC patients revealed:①It appeared more prognostic value to modify 4 substages into 3 substages in T-category; ②N-category was more concise by deleting nodal greatest dimension palpation;③ It showed that nodal parameters including level, laterality and extranodal neoplastic spread (ENS) are independent prognostic factors for NPC. N-staging criteria with RTOG guidelines for lymph node levels was set up which adapted to the requirement of conformal radiation therapy. Incorporating ENS and retropharyngeal lymph nodes into the N-staging system for NPC increases the predictive power.
