title: Tumour-node-metastasis staging of human papillomavirus negative upper aerodigestive tract cancers: a critical appraisal.
abstract: OBJECTIVE
  The tumour-node-metastasis staging system has a dynamic structure that is continuously being updated as scientific data develops. This review discusses some suggested revisions on tumour-node-metastasis staging of human papillomavirus negative upper aerodigestive tract cancers.
  
  
  METHODS
  The seventh edition of The American Joint Committee on Cancer Staging Manual was reviewed and important issues that could be considered for revision were identified and discussed.
  
  
  RESULTS
  According to our assessment of the oncological outcomes of previous studies, the following factors should be considered for revision: anterior commissure involvement and subglottic extension in laryngeal cancers; underlying bone involvement in hard palate and upper alveolar ridge cancers; tumour thickness in oral cancers; and extracapsular spread and carotid artery involvement in neck metastases.
  
  
  CONCLUSIONS
  Sufficient data on the prognostic importance of these issues have been reported. Suggested revisions in line with current knowledge on the clinical behaviour of upper aerodigestive tract cancers would improve the relevancy of staging.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery,Gazi University School of Medicine,Ankara,Turkey.
authors.forename: U
authors.initials: U
authors.lastname: Aydil
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery,University of Pittsburgh Medical Center,Pennsylvania,USA.
authors.forename: U
authors.initials: U
authors.lastname: Duvvuri
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery,Gazi University School of Medicine,Ankara,Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Kizil
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery,Memorial Ankara Hospital,Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Köybaşioğlu
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis
keywords: Head and Neck Neoplasms; Larynx; Lymphatic Metastasis; Mouth; Neoplasm Staging