Major Changes in Head and Neck Staging for 2018

Staging cancers is an important tool for oncologists to define the natural history of disease, help to predict prognosis, support the surveillance community to facilitate cancer control at the registry level, and compare clinic trials across locales and is essential as a stratification factor for clinical and translational research. Periodic updates to staging systems are necessary to accurately reflect emerging data, differentiate novel diseases, and better capture the real-world experiences of clinicians and patients. The eighth edition of the AJCC Cancer Staging Manual (TNM classification from the American Joint Committee on Cancer [AJCC] and the Union for International Cancer Control [UICC]) reflects these principles.1-4 The AJCC head and neck task force, working with their partners in the UICC, sought to maintain harmony between the two dominant world systems for cancer staging as they introduced incremental staging changes, which took effect January 1, 2018. Three major changes to head and neck staging will be highlighted in this article, including adding depth of invasion to oral cavity cancer, introducing novel pathologic and clinical staging system for high-risk human papillomavirus–positive (HPV+)–associated oropharyngeal cancer (OPC), and the incorporation of extranodal extension (ENE) in nodal characterization in high-risk HPV–negative (HPV？) and non-nasopharyngeal carcinoma. This article and the accompanying oral presentation given at the 2018 ASCO Annual Meeting will highlight the AJCC/UICC staging changes, present the rationale for the changes, and provide preliminary data that have emerged. ANATOMY Section: ChooseTop of pageAbstractANATOMY <