Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Sep;277(9):2407-2412.
doi: 10.1007/s00405-020-05979-9. Epub 2020 Apr 27.

A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status

Piotr Machczyński  1 , Ewa Majchrzak  2 , Patryk Niewinski  2 , Joanna Marchlewska  2 , Wojciech Golusiński  2
Affiliations
Review

A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status

Piotr Machczyński et al. Eur Arch Otorhinolaryngol. 2020 Sep.

Abstract

Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has increased substantially in recent decades, particularly p16-positive human papillomavirus (HPV)-related OPSCC, which has risen by 50% in western countries. HPV-positivity is the most favourable non-anatomic predictor of oropharyngeal cancer outcomes, which underscores the importance of incorporating this variable into the cancer staging system.

Methods: In the present article, we review the differences between the 7th and 8th editions of the AJCC staging system, with particular focus on the role of HPV-positivity in patients with head and neck cancer.

Results: In the previous edition (7th edition) of the AJCC/UICC manual, HPV status and its correlation with nodal metastasis were not considered, thereby leading to incorrect lymph node (N) staging and, potentially, inadequate treatment and worse outcomes. The 8th edition of the AJCC manual addresses these issues, providing more accurate discrimination between groups and better risk stratification in patients with HPV-positive OPSCC. In the future, additional adjustments are likely to be needed, such as unification of the pathological and clinical staging models.

Conclusions: The new staging system is substantially more accurate than the previous system and should be widely adopted in routine clinical practice.

Keywords: AJCC staging system; HPV-related oropharyngeal cancer; Oropharyngeal squamous cell carcinoma; TNM staging system.

PubMed Disclaimer

Comment in

References

    1. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018) Global cancer observatory: cancer today. International Agency for Research on Cancer, Lyon. https://gco.iarc.fr/today. Accessed 3 Feb 2020
    1. Hashibe M, Brennan P, Chuang SC, et al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomark Prev. 2009;18(2):541–550. doi: 10.1158/1055-9965.EPI-08-0347. - DOI - PMC - PubMed
    1. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008;26:612–619. doi: 10.1200/JCO.2007.14.1713. - DOI - PubMed
    1. Stransky N, Egloff AM, Tward AD, et al. The mutational landscape of head and neck squamous cell carcinoma. Science. 2011;333(6046):1157–1160. doi: 10.1126/science.1208130. - DOI - PMC - PubMed
    1. Majchrzak E, Szybiak B, Wegner A, Pienkowski P, Pazdrowski J, Luczewski L, Sowka M, Golusinski P, Malicki J, Golusinski W. Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature. Radiol Oncol. 2014;48(1):1–10. doi: 10.2478/raon-2013-0057. - DOI - PMC - PubMed