ArticleCancer medicine2019
The development and external validation of simplified T category classification for nasopharyngeal carcinoma to improve the prognostic value in the intensity-modulated radiotherapy era.
Article in Cancer medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature.Frontiers in oncology · 2021Pooled it
- Article
- Advances in Nasopharyngeal Carcinoma Staging: from the 7th to the 9th Edition of the TNM System and Future Outlook.Current oncology reports · 2025Review
- The Utility ofClinical Medicine Insights. Oncology · 2024Article
- Prognostic significance of MRI-based late-course tumor volume in locoregionally advanced nasopharyngeal carcinoma.Radiation oncology (London, England) · 2022Article
- Dosimetric parameters predict radiation-induced choanal stenosis in patients with nasopharyngeal carcinoma.Radiation oncology (London, England) · 2020Article
- The evolution of nasopharyngeal carcinoma staging.The British journal of radiology · 2019Review
- The development and external validation of simplified T category classification for nasopharyngeal carcinoma to improve the prognostic value in the intensity-modulated radiotherapy era.Cancer medicine · 2019Article
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11 authors.
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Abstract
backgroundIntensity-modulated radiotherapy (IMRT) provides excellent local control in nasopharyngeal carcinoma (NPC). We investigated whether simplifying 8th American Joint Committee on Cancer staging system T categories improves prognostic value.
methodsWe used 2191 NPC patients as a training set and 414 patients separately as an independent, external validation cohort.
resultsIn the training set, local relapse-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) were not significantly different between the 8th edition T2/T3 (P = 0.610, 0.380 and 0.353, respectively). Merging T2 and T3 to proposed T2 (proT2) provided significant differences in LRFS, DFS, and OS between proposed T categories. Proposed T categories had similar c-indices for LRFS, DFS, and OS (vs the 8th edition), which was validated in the external cohorts. Moreover, for DFS, the adjusted HRs of the proT2N0 (3.8), proT1N1 (3.8), and proT2N1 (6.0) subsets were similar; the adjusted HRs of the proT3N0 (7.0), proT3N1 (11.4), proT1N2 (11.0), proT2N2 (11.6), and proT3N2 (13.3) subsets were similar; the adjusted HRs of the proT1N3 (17.8), proT2N3 (15.3), and proT3N3 (26.4) subsets were similar; the results of the adjusted HRs for OS had the same rule. Defining proT1N0 as stage I; proT1N1/proT2N0-1 as stage II; proT3N0-2/proT1-2N2 as stage III; and proT1-3N3 as stage IVa generated orderly, significant differences in DFS and OS between stages in the training set and external validation cohort.
conclusionsIn the IMRT era, three T categories are more reasonable (merging T2/T3 into T2) and proT3N0-2 (the 8th edition T4N0-2) should be down-staged to stage III.
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