Prognostic classification for patients with nasopharyngeal carcinoma based on American Joint Committee on cancer staging system T and N categories
Year: 2020
Type: article
Study design: Observational Study
Abstract: Background: This study examined the current American Joint Committee on Cancer (AJCC) 8th edition staging system and proposes a new classification for nasopharyngeal carcinoma (NPC). Methods: One thousand four hundred eighteen newly diagnosed patients with NPC without distant metastasis from 1995 through 2010 were identified. Patients treated with three-dimensional conformal radiotherapy (3D-CRT) were used as the training cohort. Based on the T and N categories of the AJCC 7th edition staging system, recursive partitioning analysis (RPA) was used to derive a new grouping system for NPC. This system was validated in patients who received intensity-modulated radiation therapy (IMRT) and compared to the current AJCC staging system. Results: The RPA algorithm divided the 643 patients in the training cohort (3D-CRT group) into 3 groups. Group I included T1–3N0–1 and T1N2 diseases, group II included T2–3N2 diseases, and group III included T4 or N3 diseases. In the validation cohort (IMRT group, n=775), the 5-year overall survival rate using the AJCC 8th edition staging system were 94.0% for stage I, 93.9% for stage II, 89.2% for stage III, and 73.7% for stage IVA. With our RPA classification, the 5-year survival rate were 92.2% for group I, 86.5% for group II, and 72.7% for group III. Conclusions: Our new grouping system more accurately reflects survival outcomes for patients with NPC than the current AJCC staging system. Based on this grouping system, more patients were considered to have early-stage disease with favorable prognosis.
Institution: Koo Foundation Sun Yat-Sen Cancer Center
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3010252985