Evidence map›Paper›PMID 26588425›Full record

ArticleCancer2016

Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy.

Jian Ji Pan, Wai Tong Ng, Jing Feng Zong, Lucy L K Chan, Brian O'Sullivan, Shao Jun Lin, Henry C K Sze, Yun Bin Chen, Horace C W Choi, Qiao Juan Guo and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 196 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
196citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

196 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Optimal induction chemotherapy regimen for locoregionally advanced nasopharyngeal carcinoma: an update Bayesian network meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022
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  20. Platelet-to-lymphocyte ratio and systemic inflammation response index are the optimal combination for risk stratification in patients with nasopharyngeal carcinoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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136 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Jian Ji PanDepartment of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Wai Tong NgDepartment of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Jing Feng ZongDepartment of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Lucy L K ChanDepartment of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Brian O'SullivanDepartment of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
Shao Jun LinDepartment of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Henry C K SzeDepartment of Clinical Oncology, Queen Mary Hospital, Hong Kong, China.
Yun Bin ChenDepartment of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Horace C W ChoiDepartment of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China.
Qiao Juan GuoDepartment of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Wai Kuen KanDepartment of Diagnostic Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
You Ping XiaoDepartment of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.
Xu WeiDepartment of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
Quynh Thu LeDepartment of Radiation Oncology, Stanford University, Stanford, California.
Christine M GlastonburyDepartment of Clinical Radiology, University of California, San Francisco, California.
A Dimitrios ColevasDepartment of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Stanford, California.
Randal S WeberDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jatin P ShahDepartment of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York.
Anne W M LeeClinical Oncology Center, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundAn accurate staging system is crucial for cancer management. Evaluations for continual suitability and improvement are needed as staging and treatment methods evolve.

methodsThis was a retrospective study of 1609 patients with nasopharyngeal carcinoma investigated by magnetic resonance imaging, staged with the 7th edition of the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system, and irradiated by intensity-modulated radiotherapy at 2 centers in Hong Kong and mainland China.

resultsAmong the patients without other T3/T4 involvement, there were no significant differences in overall survival (OS) between medial pterygoid muscle (MP) ± lateral pterygoid muscle (LP), prevertebral muscle, and parapharyngeal space involvement. Patients with extensive soft tissue involvement beyond the aforementioned structures had poor OS similar to that of patients with intracranial extension and/or cranial nerve palsy. Only 2% of the patients had lymph nodes > 6 cm above the supraclavicular fossa (SCF), and their outcomes resembled the outcomes of those with low extension. Replacing SCF with the lower neck (extension below the caudal border of the cricoid cartilage) did not affect the hazard distinction between different N categories. With the proposed T and N categories, there were no significant differences in outcome between T4N0-2 and T1-4N3 disease.

conclusionsAfter a review by AJCC/UICC preparatory committees, the changes recommended for the 8th edition include changing MP/LP involvement from T4 to T2, adding prevertebral muscle involvement as T2, replacing SCF with the lower neck and merging this with a maximum nodal diameter > 6 cm as N3, and merging T4 and N3 as stage IVA criteria. These changes will lead not only to a better distinction of hazards between adjacent stages/categories but also to optimal balance in clinical practicability and global applicability.

Indexed as

Radiotherapy, Intensity-ModulatedAdolescentAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCarcinomaCarcinoma, Squamous CellChemotherapy, AdjuvantChildChinaCisplatinCohort StudiesCricoid CartilageFemaleHead and Neck NeoplasmsCisplatinnasopharyngeal cancerprognosticationTNM staging system

Identifiers

PMID26588425
PMCPMC4968037

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.