Clinical evaluation of staging system for nasopharyngeal carcinoma : Comparison of fourth and fifth editions of UICC TNM classification

Staging nasopharyngeal carcinoma (NPC) by the UICC 4th-edition TNM classification system (the old system) did not give an accurate prognosis because of the uneven distribution of patients in each stage. This system was revised in 1997 (the new system). To evaluate the performance of the new system,...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2000-12, Vol.109 (12), p.1125-1129
Main Authors: TATSUMI-TAMORI, Akiko, MIWA, Takaki, YOSHIZAKI, Tomokazu, FURUKAWA, Mitsuru
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biopsy
Carcinoma - classification
Carcinoma - mortality
Carcinoma - pathology
Carcinoma - surgery
Combined Modality Therapy
Follow-Up Studies
Humans
Japan - epidemiology
Magnetic Resonance Imaging
Medical sciences
Nasopharyngeal Neoplasms - classification
Nasopharyngeal Neoplasms - mortality
Nasopharyngeal Neoplasms - pathology
Nasopharyngeal Neoplasms - surgery
Neck Dissection
Neoplasm Staging - methods
Otorhinolaryngology. Stomatology
Prognosis
Proportional Hazards Models
Survival Analysis
Tomography, X-Ray Computed
Treatment Outcome
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Staging nasopharyngeal carcinoma (NPC) by the UICC 4th-edition TNM classification system (the old system) did not give an accurate prognosis because of the uneven distribution of patients in each stage. This system was revised in 1997 (the new system). To evaluate the performance of the new system, 35 patients with NPC who had been staged by the old system were restaged according to the new system. Restaging of the patients resulted in an overall "downstaging." Differences in the overall survival rates of the early group (stages I, II, III), stage IVA, stage IVB, and stage IVC patients were statistically significant (75%, 48%, 74%, and 0%. respectively; p = .01). T4 was a significant factor of poor outcome (hazard rate, 2.932; 95% CI, 1.667 to 8.545), whereas N3 was not (hazard rate, 0.858; 95% CI, 0.281 to 2.618). The new staging system is more useful than the old system.
ISSN:0003-4894
1943-572X
DOI:10.1177/000348940010901208