In-depth evaluation of the AJCC/UICC 1997 staging system of nasopharyngeal carcinoma: Prognostic homogeneity and proposed refinements

Nasopharyngeal carcinoma with orbital invasion

“…13 Au et al 14 described a 5-year survival rate of 30% in stage IV patients in a retrospective review of 1294 consecutive nonmetastatic NPC patients. 14 They found that for stage T4 NPC, intracranial extension/cranial nerve palsy and orbital involvement carried a more sinister prognosis relative to those with infratemporal fossa or hypopharynx involvement alone 14 Thus, with our 5-year survival rate of 28%, the results of the current study confirm that orbital involvement confers a bad prognosis in NPC patients.…”

Re-Evaluation of 6th Edition of AJCC Staging System for Nasopharyngeal Carcinoma and Proposed Improvement Based on Magnetic Resonance Imaging

“…The 5th edition of the International Union Against Cancer (UICC)/ American Joint Committee on Cancer (AJCC) staging system (1,2), which amalgamated both Western and Eastern experiences, was an even more vigorous attempt toward universal unification. Successive evaluations of the system have consistently confirmed its superiority over the previous system, in terms of improved prognostication and a more balanced distribution among the stages (3)(4)(5)(6)(7). Hence, no additional changes (except for the addition of the term ''masticator space'' as a synonym for infratemporal fossa) were introduced to the most recent UICC/AJCC 6th edition (8).…”

“…For example, a lack of separation in survival is present between the T categories. A study by Heng et al (9) found no significant difference in overall survival (OS) between Stage T1 and Stage T2b disease; other studies saw no significant difference in OS between Stage T1 and Stage T2a (5,7,10). In addition, the subsets defined by the T and N classifications that make up a given group typically have different prognoses.…”

Prognostic Value of Pretreatment Serum Alkaline Phosphatase in Nasopharyngeal Carcinoma

“…This highlights the need for accurate evaluation of NPC prognosis. The TNM classification is widely used to predict prognosis (Tang et al, 2010), but this scheme fails to capture the heterogeneous prognoses among patients sharing the T classification or the variability in survival and response to chemotherapy among NPC patients with distant metastasis (Fandi et al, 2000;Au et al, 2003). Thus, defining novel prognostic indicators is of great importance.…”