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Evolution of TNM Classification for Clinical Staging of Oral Cancer: The Past, Present and the Future

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Abstract

Purpose

The AJCC (American Joint Committee on Cancer) Cancer Staging Manual, 1st Edition, was published in 1977 which focused on the TNM classification and staging of cancer to allow easy communication, formulation of a treatment plan and predict the prognosis, among the medical fraternity.

Methods

Ever since the beginning, various modifications of the classification were introduced and released by the joint collaboration of AJCC and UICC (International Union Against Cancer) in various editions of cancer staging manuals.

Results

The present review article was kept focused onto the changes introduced in the clinical staging of cancers of oral cavity. These changes came a long way since 1st edition 1944, to the eighth edition which was published in 2017.

Conclusions

This article is a critical review on the past and present perspectives of the TNM classification of the oral cavity that were addressed and changed, adding a light on the future trends or necessary inclusions that would formulate a much easily acceptable and useful classification system.

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References

  1. American Joint Committee on Cancer and End Results Reporting (1977) Manual for staging of cancer, 1st edn. Illinois, Chicago

    Google Scholar 

  2. American Joint Committee on Cancer (1983) Manual for staging of cancer, 2nd edn. J.B. Lippincott, Philadelphia

    Google Scholar 

  3. American Joint Committee on Cancer (1988) Manual for staging of cancer, 3rd edn. J.B. Lippincott, Philadelphia

    Google Scholar 

  4. Beahrs OH, Henson DE, Hutter RVP, Kennedy BJ (eds) (1992) 4th edn. J.B. Lippincott, Philadelphia

    Google Scholar 

  5. Greene FL, Page DL, Fleming ID et al (eds) (2002) 6th edn. Springer, New York

    Google Scholar 

  6. Fleming ID, Cooper JS, Henson DE et al (eds) (1997) 5th edn. J.B. Lippincott, Philadelphia

    Google Scholar 

  7. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) (2010) 7th edn. Springer International Publishing, New York, NY

    Google Scholar 

  8. Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK et al. (eds) (2017) AJCC cancer staging manual. 8th edn. Springer International Publishing, American Joint Commission on Cancer, New York

  9. Greene FL, Sobin LH (2008) The staging of cancer: a retrospective and prospective appraisal. CA Cancer J Clin 58(3):180–90. https://doi.org/10.3322/ca.2008.0001

    Article  PubMed  Google Scholar 

  10. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP (2017) The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 67(2):93–99. https://doi.org/10.3322/caac.21388

    Article  PubMed  Google Scholar 

  11. Amit M, Liu C, Gleber-Netto FO, Kini S, Tam S, Benov A, Aashiq M, El-Naggar AK, Moreno AC, Rosenthal DI, Glisson BS (2021) Inclusion of extranodal extension in the lymph node classification of cutaneous squamous cell carcinoma of the head and neck. Cancer 127(8):1238–1245. https://doi.org/10.1002/cncr.33373

    Article  PubMed  Google Scholar 

  12. Sridharan S, Thompson LD, Purgina B, Sturgis CD, Shah AA, Burkey B, Tuluc M, Cognetti D, Xu B, Higgins K, Hernandez-Prera JC (2019) Early squamous cell carcinoma of the oral tongue with histologically benign lymph nodes: a model predicting local control and vetting of the eighth edition of the American Joint Committee on Cancer pathologic T stage. Cancer 125(18):3198–207

    Article  PubMed  Google Scholar 

  13. Ho AS, Luu M, Kim S, Tighiouart M, Mita AC, Scher KS, Zumsteg ZS (2021) Nodal staging convergence for HPV− and HPV+ oropharyngeal carcinoma. Cancer 127(10):1590–1597. https://doi.org/10.1002/cncr.33414

    Article  CAS  PubMed  Google Scholar 

  14. Wittekind C, Compton CC, Greene FL, Sobin LH (2002) TNM residual tumor classification revisited. Cancer 94(9):2511–2516. https://doi.org/10.1002/cncr.10492

    Article  PubMed  Google Scholar 

  15. Hoekstra HJ, Wobbes T, Heineman E, Haryono S, Aryandono T, Balch CM (2016) Fighting global disparities in cancer care: a surgical oncology view. Ann Surg Oncol 23:2131–2136. https://doi.org/10.1016/j.wjorl.2019.06.001

    Article  PubMed  PubMed Central  Google Scholar 

  16. Low TH, Gao K, Elliott M, Clark JR (2015) Tumor classification for early oral cancer: re-evaluate the current TNM classification. Head Neck 37(2):223–8. https://doi.org/10.1002/hed.23581

    Article  Google Scholar 

  17. Lee NC, Eskander A, Park HS, Mehra S, Burtness BA, Husain Z (2019) Pathologic staging changes in oral cavity squamous cell carcinoma: stage migration and implications for adjuvant treatment. Cancer 125(17):2975–2983. https://doi.org/10.1002/cncr.32161

    Article  PubMed  Google Scholar 

  18. Gospodarowicz MK, Miller D, Groome PA, Greene FL, Logan PA, Sobin LH (2004) The process for continuous improvement of the TNM classification. Cancer 100(1):1–5. https://doi.org/10.1002/cncr.11898

    Article  PubMed  Google Scholar 

  19. Zanoni DK, Patel SG, Shah JP (2019) Changes in the 8th edition of the American Joint Committee on Cancer (AJCC) staging of head and neck cancer: rationale and implications. Curr Oncol Rep 21(6):52. https://doi.org/10.1007/s11912-019-0799-x

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bobdey S, Mair M, Nair S, Nair D, Balasubramaniam G, Chaturvedi P (2018) A nomogram based prognostic score that is superior to conventional TNM staging in predicting outcome of surgically treated T4 buccal mucosa cancer: time to think beyond TNM. Oral Oncol 81:10–15. https://doi.org/10.1002/cncr.29932

    Article  PubMed  Google Scholar 

  21. Kato MG, Baek CH, Chaturvedi P, Gallagher R, Kowalski LP, Leemans CR, Warnakulasuriya S, Nguyen SA, Day TA (2020) Update on oral and oropharyngeal cancer staging-International perspectives. World J Otorhinolaryngol Head Neck Surg 6(01):66–75. https://doi.org/10.1016/j.wjorl.2019.06.001

    Article  PubMed  PubMed Central  Google Scholar 

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Nagesh, M., Gowtham, S., Bharadwaj, B. et al. Evolution of TNM Classification for Clinical Staging of Oral Cancer: The Past, Present and the Future. J. Maxillofac. Oral Surg. 22, 710–719 (2023). https://doi.org/10.1007/s12663-023-01915-6

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