title: Future of the TNM classification and staging system in head and neck cancer.
abstract: Staging systems for cancer, including the most universally used TNM classification system, have been based almost exclusively on anatomic information. However, the question arises whether staging systems should be based on this information alone. Other parameters have been identified that should be considered for inclusion in classification systems like the TNM. This is all the more important, as a shift toward nonsurgical treatments for head and neck cancer has been made over the years. For these treatment modalities tumor/biologic characteristics next to anatomic information may be particularly important for treatment choice and outcome. The shortcomings of the current TNM classification system will be discussed, along with suggestions for improvement and expansion of the TNM system based on tumor, patient, and environment-related factors. Further improvement of the TNM classification is expected to result in better treatment choices, outcome and prognostication of patients with head and neck cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. r.takes@kno.umcn.nl
authors.forename: Robert P
authors.initials: RP
authors.lastname: Takes
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Missak
authors.initials: M
authors.lastname: Haigentz
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.forename: Vincent
authors.initials: V
authors.lastname: Van der Poorten
authors.forename: Robert
authors.initials: R
authors.lastname: Hermans
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rodrigo
authors.forename: Kenneth O
authors.initials: KO
authors.lastname: Devaney
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D006258:Head and Neck Neoplasms / Q000145:classification* / Q000473:pathology; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis