Future of the TNM classification and staging system in head and neck cancer.
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.
Takes
Robert P
RP
Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. r.takes@kno.umcn.nl
Rinaldo
Alessandra
A
Silver
Carl E
CE
Piccirillo
Jay F
JF
Haigentz
Missak
M
Suárez
Carlos
C
Van der Poorten
Vincent
V
Hermans
Robert
R
Rodrigo
Juan Pablo
JP
Devaney
Kenneth O
KO
Ferlito
Alfio
A
D006258:Head and Neck Neoplasms / Q000145:classification* / Q000473:pathology; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis