Head and neck cancers—major changes in the American Joint Committee on cancer eighth edition cancer staging manual

• Published in: CA: a cancer journal for clinicians Vol. 67; no. 2; pp. 122 - 137
• Main Authors: Lydiatt, William M., Patel, Snehal G., O'Sullivan, Brian, Brandwein, Margaret S., Ridge, John A., Migliacci, Jocelyn C., Loomis, Ashley M., Shah, Jatin P.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2017
• Subjects: Algorithms; American Joint Committee on Cancer (AJCC); Carcinoma, Squamous Cell - pathology; depth of invasion; extranodal extension; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - pathology; Human papillomavirus; human papillomavirus (HPV); human papillomavirus‐associated cancer; Humans; Melanoma; Metastasis; Neoplasm Staging; Neoplasms, Unknown Primary - pathology; Oncology; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - virology; oropharynx; Papillomavirus Infections - complications; Practice Guidelines as Topic; prognosis; staging; Tumors; United States; human papillomavirus (HPV); depth of invasion; human papillomavirus-associated cancer; American Joint Committee on Cancer (AJCC); head and neck cancer; oropharynx; prognosis; staging; extranodal extension
• ISSN: 0007-9235; 1542-4863
• DOI: 10.3322/caac.21389

Answer questions and earn CME/CNE The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, introduces significant modifications from the prior seventh edition. This article details several of the most significant modifications, and the rationale for the revisions, to alert the reader to evolution of the field. The most significant update creates a separate staging algorithm for high‐risk human papillomavirus‐associated cancer of the oropharynx, distinguishing it from oropharyngeal cancer with other causes. Other modifications include: the reorganizing of skin cancer (other than melanoma and Merkel cell carcinoma) from a general chapter for the entire body to a head and neck‐specific cutaneous malignancies chapter; division of cancer of the pharynx into 3 separate chapters; changes to the tumor (T) categories for oral cavity, skin, and nasopharynx; and the addition of extranodal cancer extension to lymph node category (N) in all but the viral‐related cancers and mucosal melanoma. The Head and Neck Task Force worked with colleagues around the world to derive a staging system that reflects ongoing changes in head and neck oncology; it remains user friendly and consistent with the traditional tumor, lymph node, metastasis (TNM) staging paradigm. CA Cancer J Clin 2017;67:122–137. © 2017 American Cancer Society.