Changes in the 8th Edition of the TNM Classification for Head and Neck Cancer: Implication for the radiologist.

Congress:

ECR 2018

Poster Number:

C-2212

Type:

Educational Exhibit

Keywords:

Cancer, Staging, MR, CT, Head and neck

Authors:

E. Serrano Alcalá¹, E. Grive¹, C. Mazzara Bou¹, A. A. MARIN SUAREZ², V. Querol Borras¹, S. Grossi³, A. M. Gallart Ortuño¹, M. Rovira¹; ¹Barcelona/ES, ²08029, BARCELONA/ES, ³Parma (PR)/IT

DOI:

10.1594/ecr2018/C-2212

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2212

Table 1

Table 2

Table 3

Fig. 1: Patient with right tonsilar carcinoma (T2). Coronal STIR demonstrates multiple...

Learning objectives

To describe the main modifications in the updated Head and Neck TNM classification with relevance to Radiology, providing significant examples.

Background

Head and neck cancer (HNC) constitute a heterogeneous group of upper aerodigestive tract malignancies originated in the lip, oral cavity, hypopharynx, oropharynx, nasopharynx or larynx, that togetherconstitute the seventh most common cancer worldwide. Oral cavity and laryngeal cancers are the most common head and neck cancers globally, and the squamous cell carcinoma represents 89% of them. Although tobacco and alcoholconsume had been historically the main risk factors to develop HNC, human papillomavirus (HPV) has been recognized over the past decade as another important cause of...

Findings and procedure details

Main modifications in the updated Head and Neck TNM classification with relevance to radiologist: Separate classifications for clinical and pathological neck nodes New classification for high-risk human papillomavirus-associated cancer of the oropharynx (Oropharynx p16+). T or N modifications: .Oral cavity .Nasopharynx .Inclusion of extranodal extension NEW CLASSIFICATION OROPHARYNX P16+. The key update is the new staging for high risk human papillomavirus (HPV)-related oropharyngeal cancer distinguishing it from oropharyngeal cancer due to other causes. The incidence of HPV-HNC has risen radically in the last decades, in...

Conclusion

The 8th edition of the TNM Classification of Malignant Tumours introduces significant modifications for Head and Neck cancer. Radiologist should be aware of the updated classification system to provide useful and accurate staging information.

Personal information

References

(1). Rettig E, D’Souza G. Epidemiology of Head and Neck Cancer. Surgical Oncology Clinics of North America. 2015;24(3):379-396. (2). Crescenzib D, Laus M, Radici M, Croce A. TNM classification of the oral cavity carcinomas: some suggested modifications. Otolaryngologia Polska. 2015;69(4):21-30. (3) Pentenero M, Gandolfo S, Carrozzo M: Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck 2005;27:1080–1091. (4). Lydiatt, W., Patel, S., O'Sullivan, B., Brandwein, M., Ridge, J., Migliacci,...