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Oncotarget. 2017 Aug 2;8(41):70586-70594. doi: 10.18632/oncotarget.19829. eCollection 2017 Sep 19.

Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy.

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Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, P.R. China.
Department of Radiation Oncology, Liuzhou Worker Hospital, Liuzhou 545000, Guangxi, P.R. China.
Department of Radiation Oncology, First People's Hospital of Yulin City, Yulin 537000, Guangxi, P.R. China.
Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, P.R. China.
Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, Guilin 541000, Guangxi, P.R. China.
Department of Radiation Oncology, Wuzhou Red Cross Hospital, Wuzhou 543000, Guangxi, P.R. China.


An accurate TNM staging system is crucial for treatment guidance and prognosis prediction in nasopharyngeal carcinoma (NPC) patients. In this retrospective study, we evaluated the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system for NPC treated with intensity-modulated radiotherapy (IMRT). A total of 608 patients with biopsy-proven, non-metastatic NPC, treated with IMRT between January 2008 and March 2010, were enrolled. The 5-year overall survival (OS), disease-free survival (DFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 81.5%, 80.1%, 86.0%, and 81.1%, respectively. The LRFS rates of patients with stages T1 vs. T2, T2 vs. T3, and T1 vs. T3 did not differ between the 7th and 8th editions. By contrast, the DMFS rates of patients with N0 vs. N1, N1 vs. N2, and N2 vs. N3 differed between the 8th and the 7th editions, though no difference was observed between N3a and N3b, according to the 7th edition. The difference in OS between stages II and III, and between stages III and IVa, was larger according to the 8th edition than the 7th edition. There was no difference in the OS between stages I and II. These data indicate that in the IMRT era, the 8th edition staging system can predict the prognosis of NPC patients more accurately than the 7th edition.


UICC/AJCC staging system; differences; intensity-modulated radiotherapy; nasopharyngeal carcinoma; prognosis

Conflict of interest statement

CONFLICTS OF INTEREST The authors indicated no actual or potential conflicts of interest.

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