A review of head and neck cancer staging system in the TNM classification of malignant tumors (eighth edition)

Head and Neck Cancer Study Group (HNCSG); Nobuya Monden; Takahiro Asakage; Naomi Kiyota; Akihiro Homma; Kazuto Matsuura; Nobuhiro Hanai; Takeshi Kodaira; Sadamoto Zenda; Hirofumi Fujii; Makoto Tahara; Tomoya Yokota; Tetsuo Akimoto; Shigemichi Iwae; Tetsuro Onitsuka; Takenori Ogawa; Susumu Okano; Shunji Takahashi; Yasushi Shimizu; Koichiro Yonezawa; Ryuichi Hayashi

doi:10.1093/jjco/hyz052

A review of head and neck cancer staging system in the TNM classification of malignant tumors (eighth edition)

Jpn J Clin Oncol. 2019 Jul 1;49(7):589-595. doi: 10.1093/jjco/hyz052.

Authors

Head and Neck Cancer Study Group (HNCSG); Nobuya Monden¹, Takahiro Asakage², Naomi Kiyota³, Akihiro Homma⁴, Kazuto Matsuura⁵, Nobuhiro Hanai⁶, Takeshi Kodaira⁷, Sadamoto Zenda⁸, Hirofumi Fujii⁹, Makoto Tahara¹⁰, Tomoya Yokota¹¹, Tetsuo Akimoto⁸, Shigemichi Iwae¹², Tetsuro Onitsuka¹³, Takenori Ogawa¹⁴, Susumu Okano¹⁰, Shunji Takahashi¹⁵, Yasushi Shimizu¹⁶, Koichiro Yonezawa¹², Ryuichi Hayashi¹⁷

Affiliations

¹ Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
² Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
³ Department of Medical Oncology/Hematology, Kobe University Hospital/Cancer Center, Kobe, Japan.
⁴ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
⁵ Division of Head and Neck Surgery, Miyagi Cancer Center, Japan.
⁶ Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
⁷ Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
⁸ Department of Radiation Oncology, National Cancer Center Hospital East.
⁹ Department of Clinical Oncology, Jichi Medical University, Japan.
¹⁰ Department of Head and Neck Medical Oncology, National Cancer Center Hospital East.
¹¹ Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
¹² Department of Head and Neck Surgery, Hyogo Cancer Center, Hyogo, Japan.
¹³ Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital, Japan.
¹⁵ Department of Medical Oncology, Cancer Institute Hospital.
¹⁶ Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
¹⁷ Department of Head and Neck Surgery, National Cancer Center Hospital East, Japan.

PMID: 31194232
DOI: 10.1093/jjco/hyz052

Abstract

A number of major modifications were made to the classification of head and neck carcinomas in the eighth edition of the American Joint Committee on Cancer, Cancer Staging Manual and Union for International Cancer Control TNM classification of Malignant Tumors. These modifications were aimed at improving the prognosis prediction accuracy of the system. In this article, we review the new edition of the TNM classification system. Among the several changes in the new system, a separate algorithm for p16-positive oropharyngeal carcinoma was included, as were new chapters on 'Head and Neck Skin Carcinoma' and 'Unknown Primary Carcinoma-Cervical Nodes.' Changes to Tumor (T) classification were made by introducing the depth of invasion of oral carcinoma, whereas changes to Node (N) classification were made by adding extra-nodal extension. It is believed that these changes will help improve the accuracy of the system in the prediction of prognosis. However, it is necessary to verify their validity through further clinical research.

Keywords: TNM classification; head and neck neoplasms; p16 gene.

Publication types

Review

MeSH terms

Algorithms
Head and Neck Neoplasms / pathology*
Humans
Neoplasm Staging
Neoplasms, Unknown Primary / pathology
Prognosis