Aims and objectives
The purpose of our review was to assess the impact of the updated AJCC 2018 guidelines on imaging and on the daily practice of general radiologists and neuroradiologists alike.
Methods and materials
We performed a review of the AJCC 8th edition Cancer Staging Manual implications for imaging and the impact that it should have on neuroradiologists and general radiologists alike going foward,
using examples and images from our own practice.
Results
We performed a review of this latest edition with the view of highlighting the pertinent changes whilst providing examples from our own practice.
The changes include:
Depth of invasion (DOI)
Oropharynx being divided into 3 separate chapters; nasopharynx,
HPV positive oropharyngeal squamous cell carcinoma (SCC),
hypopharynx and HPV negative oropharyngeal SCC.
Extranodal extension
Neck nodal SCC metastatsis with unknown primary
Including DOI in the staging of OPSCC will better discriminate the higher risk small cancers as demonstrated by deeply invasive tumours from those with less...
Conclusion
In conclusion the 8th ediiton head and neck AJCC cancer staging manual incorporates signficiant changes.
Here we highlight some of the pertinent changes relevant to radiologists including:
DOI,
which is a pathological rather than a radiological measurement,
which has changed the staging of some head and neck tumours.
HPV +ve and HPV -ve SCC - the former being small,
well defined,
and less likely to invade local structures,
whereas the latter tend to be large,
ill defined,
invade surrounding structures and demonstrate necrotic rather than...
References
Setting the Stage for 2018: How the Changes in the American Joint Committe on Cancer/Union for Internaional Cancer Control Cancer Staging Manual Eighth Edition Impact Radiologists.CM Glastonbury,
SK Murkherji,
B O'Sullivan and W.M.
Lydiatt,American Journal of Neuroradiology October 2017
https://cancerstaging.org/About/news/Pages/Head-and-Neck-cancers%E2%80%94major-changes-in-the-American-Joint-Committee-on-cancer-eighth-edition-cancer-staging-manual.aspx