Staging of Nasopharyngeal Carcinoma Based on the 8th Edition of the AJCC/UICC Staging System

Abstract The tumor, node, metastases (TNM) staging system for nasopharyngeal carcinoma (NPC) has undergone important refinement throughout the years to match the evolving technology in imaging and the changing landscape of treatment. In the latest edition of the American Joint Committee for Cancer/Union for International Cancer Control TNM staging system, stage-defining criteria are more precise and more applicable when magnetic resonance imaging is commonly used. It has been demonstrated to have stronger prognostic power in contemporary clinical series with the use of modern treatment technique including intensity-modulated radiotherapy and combination chemotherapy. Nonetheless, there is room for further improvement in the prognostication of NPC as other factors including novel biomarkers, nomograms, radiotherapy dosimetry, and certain clinical parameters have been identified to influence the treatment outcome. This chapter will go through the progress in the staging system of NPC and future directions in achieving a more personalized method of prognostication.