Dahlstrom et al proposed a staging system for HPV-related oropharyngeal cancer. This may better predict survival for this subset of patients. The authors are from the University of Texas MD Anderson Cancer Center in Houston.
Patient selection: invasive HPV-positive oropharyngeal cancer
Parameters:
(1) T stage, based on oropharyngeal cancer
(2) N stage, based on nasopharyngeal cancer
(3) distant metastases
|
Tumor Status for Oropharyngeal Cancer |
T Status |
|
<= 2 cm in diameter |
T1 |
|
2.01 to 4.0 cm in diameter |
T2 |
|
> 4 cm |
T3 |
|
extension to lingual surface of the epiglottis |
T3 |
|
advanced disease with invasion into adjacent structures |
T4 |
|
Nodal Status for Nasopharyngeal Cancer |
N Status |
|
no lymph node metastasis |
N0 |
|
unilateral, <= 6 cm, above supraclavicular fossa |
N1 |
|
unilateral or bilateral, <= 6 cm, retropharyngeal |
N1 |
|
bilateral, <= 6 cm, above the supraclavicular fossa |
N2 |
|
metastasis > 6 cm |
N3 |
|
metastasis to node in supraclavicular fossa |
N3 |
where:
• A midline lymph node is considered ipsilateral.
|
Distant Mets |
T Status |
N Status |
Stage |
|
absent |
T1 |
N0 to N2 |
IA |
|
absent |
T2 |
N0 to N2 |
IB |
|
absent |
T3 |
N0 to N2 |
II |
|
absent |
T1 to T3 |
N3 |
II |
|
absent |
T4 |
NA |
III |
|
present |
NA |
NA |
IV |
|
Stage |
5 Year Overall Survival |
|
IA |
94% |
|
IB |
87% |
|
II |
76% |
|
III |
69% |
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
