BACKGROUND: An accurate staging system is crucial for @entity5 management. Evaluations for continual suitability and improvement are needed as staging and treatment methods evolve. METHODS: This was a retrospective study of 1609 @entity1 with @entity189 investigated by magnetic resonance imaging, staged with the 7th edition of the American Joint Committee on @entity5 (AJCC)/International Union Against @entity5 (UICC) staging system, and irradiated by intensity-modulated radiotherapy at 2 centers in Hong Kong and mainland China. RESULTS: Among the @entity1 without other T3/T4 involvement, there were no significant differences in overall survival (OS) between @entity121 ( @entity121 )        lateral pterygoid muscle (LP), prevertebral muscle, and parapharyngeal space involvement. @entity1 with extensive soft tissue involvement beyond the aforementioned structures had poor OS similar to that of @entity1 with intracranial extension and/or @entity129 . Only 2% of the @entity1 had lymph nodes   >   6   cm above the supraclavicular fossa (SCF), and their outcomes resembled the outcomes of those with low extension. Replacing SCF with the lower neck (extension below the caudal border of the cricoid cartilage) did not affect the hazard distinction between different N categories. With the proposed T and N categories, there were no significant differences in outcome between T4N0-2 and T1-4N3 disease. CONCLUSIONS: After a review by AJCC/UICC preparatory committees, the changes recommended for the 8th edition include changing @entity121 /LP involvement from T4 to T2, adding prevertebral muscle involvement as T2, replacing SCF with the lower neck and merging this with a maximum nodal diameter   >   6   cm as N3, and merging T4 and N3 as stage IVA criteria. These changes will lead not only to a better distinction of hazards between adjacent stages/categories but also to optimal balance in clinical practicability and global applicability. @entity5 2016;122:546-558.    2015 American @entity5 Society.

Proposal for the 8th edition of the AJCC/UICC staging system for XXXX in the era of intensity-modulated radiotherapy.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity129 :: ('MESH:D003389', 'Disease') :: ['cranial nerve palsy'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'Cancer'] @entity189 :: ('MESH:D002277', 'Disease') :: ['nasopharyngeal carcinoma'] @entity121 :: ('MESH:D009135', 'Disease') :: ['medial pterygoid muscle', 'MP']
@entity5 :: (MESH:D009369,Disease) :: ['nasopharyngeal cancer']
