A Clinical Evaluation Of The Chinese2008Staging System For Nasopharyngeal Carcinoma

Objective:Based on Evidence-based medicine,The Chinese2008staging system for nasopharyngeal carcinoma (NPC) was a common set of recommendations by initial revision of the previous1992staging system. With retrospective analysis for NPC in189cases, this study was to verify the Chinese2008staging system and to provide evidence for its further revision.Materials and Methods:Between January2010and October2010,189patients with newly diagnosed, non-disseminated biopsy-proven nasopharyngeal carcinoma, presented at the Department of Radiotherapy of Xiang Ya hospital, Central South University, were entered into this study. All patients received magnetic resonance imaging examination of the neck and nasopharynx before treatment.According to the principle of the staging system,the indices of hazard discrimination,prognostic value, and distribution were used to evaluate the Chinese2008staging system.Result:According to the Chinese2008staging system, the distribution of stage group for the whole series was2.12%for the stage I,11.11%stage Ⅱ,44.97%stage Ⅲ,41.80%stage ⅣA. As for hazard discrimination, the2.5-year local relapse-free survival (LRFS) rates for T1-T4patients were100%,100%,95.13%and87.82%respectively. The2.5-year distant metastasis failure-free survival (DMFS) rates for N0-N3patients were100%,95.12%,90.82%and79.9%,respectively. The2.5-year overall survival (OS) rates for stage Ⅰ-Ⅳ patients were100%,95.2%,91.7%and78.2%respectively. The2.5-year (DFS) Multivariate analyses showed that age, cervical nodal level, extranodal neoplastic spread, Cranial nerves and intracranial (cavernous sinus, dural meninges) extension were independent prognostic factors for OS and DMFS, but maximal axial diameter and laterality were not.Conclusion:Using the Chinese2008staging system for NPC produces an acceptable distribution of patient numbers.Stage group, T classification, and N classification represent independent prognosis factors for major endpoints. However, there are several deficiencies exist the current system yet.