A comparison of staging systems for nasopharyngeal carcinoma in Taiwan

The fifth edition of the American Joint Committee on Cancer (AJCC) staging manual defines new rules for staging nasopharyngeal carcinoma. The authors tested the value of this new system by applying these rules retrospectively to their previously treated patients and comparing the results with those obtained using the fourth edition of the AJCC staging manual. Information from 196 patients who had biopsyproven squamous cell carcinoma of the nasopharynx that was treated with definitive-intent radiation therapy alone or combined chemo-radiation therapy (CCRT) at one institution provided the data base for this analysis. The extent of disease of each patient was staged according to the rules of 1) the fourth edition of the AJCC staging manual, and 2) the fifth edition of the AJCC staging manual. The new system appears to be better than the previous system. It separated patients into cohorts of more equal size than did the previous system. It also correlated with outcome for the study population more appropriately than did the fourth edition of the AJCC staging manual. The fifth edition of the AJCC staging manual appears to be an improvement over the previous edition for the staging of nasopharyngeal carcinoma.