title: Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual.
abstract: Answer questions and earn CME/CNE The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, introduces significant modifications from the prior seventh edition. This article details several of the most significant modifications, and the rationale for the revisions, to alert the reader to evolution of the field. The most significant update creates a separate staging algorithm for high-risk human papillomavirus-associated cancer of the oropharynx, distinguishing it from oropharyngeal cancer with other causes. Other modifications include: the reorganizing of skin cancer (other than melanoma and Merkel cell carcinoma) from a general chapter for the entire body to a head and neck-specific cutaneous malignancies chapter; division of cancer of the pharynx into 3 separate chapters; changes to the tumor (T) categories for oral cavity, skin, and nasopharynx; and the addition of extranodal cancer extension to lymph node category (N) in all but the viral-related cancers and mucosal melanoma. The Head and Neck Task Force worked with colleagues around the world to derive a staging system that reflects ongoing changes in head and neck oncology; it remains user friendly and consistent with the traditional tumor, lymph node, metastasis (TNM) staging paradigm. CA Cancer J Clin 2017;67:122-137. © 2017 American Cancer Society.
authors.affiliation: Chair-Elect Department of Surgery Nebraska Methodist Hospital and Clinical Professor of Surgery, Creighton University, Omaha, NE.
authors.forename: William M
authors.initials: WM
authors.lastname: Lydiatt
authors.affiliation: Assistant Professor of Surgery, Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Professor, Department of Radiation Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.affiliation: Professor and Vice Chair for Clinical Affairs, Department of Pathology and Anatomical Sciences, State University of New York (SUNY) at the University at Buffalo, Buffalo, NY.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Brandwein
authors.affiliation: Chief, Head and Neck Surgery Section, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
authors.affiliation: Research Project Manager, Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Jocelyn C
authors.initials: JC
authors.lastname: Migliacci
authors.affiliation: Statistician, National Cancer Data Base, American College of Surgeons, Chicago, IL.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Loomis
authors.affiliation: Chief, Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
mesh_terms: D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D009367:Neoplasm Staging; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications; D017410:Practice Guidelines as Topic; D014481:United States
keywords: American Joint Committee on Cancer (AJCC); depth of invasion; extranodal extension; head and neck cancer; human papillomavirus (HPV); human papillomavirus-associated cancer; oropharynx; prognosis; staging