Li Jing, Zou Xiong, Wu Yun-Long, Guo Jing-Cui, Yun Jing-Ping, Xu Miao, Feng Qi-Sheng, Chen Li-Zhen, Bei Jin-Xin, Zeng Yi-Xin, Chen Ming-Yuan
Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China; Department of Experimental Research, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou 510060, P. R. China; Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou 510060, P. R. China.
PLoS One. 2014 Dec 23;9(12):e116261. doi: 10.1371/journal.pone.0116261. eCollection 2014.
The International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM staging system of nasopharyngeal carcinoma (NPC) is the most important system for survival prediction. The TNM 7th edition UICC/AJCC TNM staging system for NPC was adopted in January 2009, and is now internationally recommended. In comparison with the TNM 6th edition, there were several revisions in the new edition staging system. This study aims to evaluate the prognostic value of the TNM 7th edition for NPC patients in comparison with the TNM 6th edition.
Clinical data of 2,629 NPC patients from the Sun Yat-sen University Cancer Center between January 2006 and December 2010 were retrospectively collected and all the patients were restaged according to the criteria of the TNM 6th edition and TNM 7th edition UICC/AJCC staging manual. Univariate and multivariate COX proportional hazards analyses were applied to evaluate the prognostic values between adjacent stage categories of the TNM 6th edition and TNM 7th edition.
In comparison with the TNM 6th edition, a significant alteration of the distribution of N categories was observed when the TNM 7th edition was applied (χ2 = 20.589, P<0.001), with 119 (119/670, 17.8%) patients up-staging from N0 to N1. With regard to T and overall stage, 37 (37/561, 6.6%) patients were down-staged from T2a with the TNM 6th edition to T1 with the TNM 7th edition, and finally two patients were up-staged to overall stage II (2/118, 1.7%). Moreover, the survival curves were significantly segregated (P<0.05) between T1 and T2 as well as N1 and N2 with the TNM 7th edition.
The TNM 7th edition led to a significant alteration in the distribution of N categories and it is superior to the TNM 6th edition in predicting the frequency of overall survival and distant metastasis-free survival.
国际抗癌联盟/美国癌症联合委员会（UICC/AJCC）鼻咽癌（NPC）TNM分期系统是预测生存的最重要系统。UICC/AJCC第7版NPC TNM分期系统于2009年1月采用，目前是国际推荐的。与第6版TNM相比，新版分期系统有几处修订。本研究旨在评估第7版TNM对NPC患者的预后价值，并与第6版进行比较。
回顾性收集2006年1月至2010年12月中山大学肿瘤防治中心2629例NPC患者的临床资料，所有患者均根据UICC/AJCC第6版和第7版TNM分期手册标准重新分期。应用单因素和多因素COX比例风险分析评估第6版和第7版TNM相邻分期类别的预后价值。
与第6版TNM相比，应用第7版TNM时观察到N分类分布有显著变化（χ2 = 20.589，P < 0.001），119例（119/670，17.8%）患者从N0上调至N1。关于T和总分期，37例（37/561，6.6%）患者从第6版TNM的T2a下调至第7版TNM的T1，最终2例患者上调至总分期II期（2/118，1.7%）。此外，第7版TNM中T1和T2以及N1和N2之间的生存曲线有显著分离（P < 0.05）。
第7版TNM导致N分类分布有显著变化，在预测总生存频率和无远处转移生存方面优于第6版TNM。
