Stages and prognosis of nasopharyngeal cancer

Posted by Specialist Doctor I Nguyen Thi Minh Thuyen - Pathologist - Laboratory Department - Vinmec Danang International General Hospital

After being diagnosed with nasopharyngeal cancer (NPC), doctors will try to determine if it has spread and, if so, how far. This is called staging to describe how serious the cancer is and to choose the best treatment. Doctors also use cancer stage when talking about survival statistics.

The earliest stage of nasopharyngeal cancer (NPC) is stage 0, also known as carcinoma in situ (CIS). Other stages I through IV, eg stage 3 nasopharyngeal cancer or stage 4 nasopharyngeal cancer.
Some stages are further subdivided, using capital letters (A, B) , etc.). As a rule, the lower the number, the less the cancer has spread. A higher number, like stage IV, means the cancer has spread more. And in a period, the preceding letter means the lower stage. Although each patient is individual, cancers of the same stage often have a similar prognosis and are often treated in a similar way.

The staging system used for nasopharyngeal cancer is the American Cancer Commission (AJCC) TNM system, which is based on 3 key pieces of information:
Spread of the primary tumor (T-tumor): How far has the tumor grown to nearby structures? Spread to nearby lymph nodes (N-lymph node): Has cancer spread to nearby lymph nodes in the neck? If so, how big are they? Spread (metastasis) to distant sites (M-metastasis): Has the cancer spread to distant parts of the body? (most commonly lung, liver, bone, or lymph nodes in distant parts of the body.) This classification is mainly based on the results of biopsies and imaging tests. The numbers or letters after T, N, and M provide more details about each of these elements.
Once the T, N, and M information of a cancer is determined, this information is combined called a stage group to designate an overall stage. The system described below is the most recent AJCC system for nasopharyngeal cancer, from January 2018.
Oropharyngeal cancer staging can be complex. If you have questions about the stage of your cancer and what it means, ask your doctor to explain it to you in an easy-to-understand way.
SEE ALSO: Pictures of nasopharyngeal cancer through stages

Many people often wonder how long nasopharyngeal cancer can live? To know the prognosis of the disease, the doctor needs to classify the stages of nasopharyngeal cancer. The following is information about the stages of nasopharyngeal cancer according to the AJCC:
2.1. Stage 0 (cancer in situ) Tis N0 M0
The tumor is only in the top layer of cells lining the inside of the nasopharynx and has not grown deeper (Tis). Has not spread to nearby lymph nodes (N0) Has not spread to distant parts of the body (M0). 2.2. Stage I T1 N0 M0
The tumor is located in the nasopharynx, which may also have grown into the pharynx (the part of the pharynx at the back of the mouth) and/or the nasal cavity but not further (T1). Has not spread to nearby lymph nodes (N0) Has not spread to distant parts of the body (M0). 2.3. Stage II T1/T0 N1 M0
Tumor is located in the nasopharynx, may also extend to the pharynx (the part of the pharynx behind the mouth) and/or the nasal cavity but not further (T1). OR no tumor was seen in the nasopharynx, but cancer was found in the lymph nodes in the neck and Epstein-Barr virus (EBV) was positive, making it very likely to be NPC (T0). Cancer has spread to one or more lymph nodes on one side of the neck, or has spread to lymph nodes at the back of the throat. In both cases, none of the lymph nodes were larger than 6 cm (N1). Cancer has not spread to distant parts of the body (M0). OR
T2 N0/N1 M0
The tumor has grown to tissues on the left or right side of the upper part of the throat, but not to the bone (T2). Has not spread to nearby lymph nodes (N0). OR, has spread to 1 or more lymph nodes on one side of the neck, or has spread to lymph nodes at the back of the throat. In both cases, none of the lymph nodes were larger than 6 cm (N1). Has not spread to distant parts of the body (M0). 2.4. Stage III T1/T0 N2 M0
The tumor is located in the nasopharynx, may also have grown into the pharynx (the part of the pharynx behind the mouth) and/or the nasal cavity but not further (T1). OR no tumor was seen in the nasopharynx, but cancer was found in the lymph nodes in the neck and Epstein-Barr virus (EBV) was positive, making it very likely to be NPC (T0). Has spread to lymph nodes on both sides of the neck, none larger than 6 cm (N2). Has not spread to distant parts of the body (M0). OR
T2 N2 M0
The tumor has grown to tissues on the left or right side of the upper part of the throat, but not to the bone (T2). Has spread to lymph nodes on both sides of the neck, none larger than 6 cm (N2). Has not spread to distant parts of the body (M0).

OR
T3 N0 to N2 M0
The tumor has grown to the sinuses and/or nearby bone (T3). With or without spread to nearby lymph nodes in the neck or back of the throat, but none larger than 6 cm (N0 to N2). Has not spread to distant parts of the body (M0). 2.5. Stage IV IVA
T4 N0 to N2 M0
The tumor has grown to the skull and/or cranial nerves, hypopharynx (lower part of the pharynx), major salivary glands, or eyes, or nearby tissues (T4). ). With or without spread to nearby lymph nodes in the neck or back of the throat, but none larger than 6 cm (N0 to N2). Has not spread to distant parts of the body (M0). OR
T any N3 M0
The tumor may or may not have grown to structures outside the oropharynx (any T). Has spread to lymph nodes larger than 6 cm or located in the shoulder area just above the collarbone (N3). Has not spread to distant parts of the body (M0). IVB T any N any M1
The tumor may or may not have grown into structures outside the oropharynx (any T). May or may not have spread to nearby lymph nodes (any N). Has spread to distant parts of the body (M1). The following additional categories are not listed:
TX: Tumor could not be evaluated due to lack of information. NX: Nearby lymph nodes cannot be assessed due to lack of information.

Survival rates can tell you what percentage of people with the same type and stage of cancer are still alive for a certain amount of time (usually 5 years) after they're diagnosed. It's important to understand that rates Survival rates are estimates and are often based on previous studies of a large number of people with a particular cancer, but cannot predict what will happen in any particular case. These statistics can be confusing and can leave you wondering, talk to your doctor about these numbers in your case.
3.1. What is the 5-year relative survival rate? Relative survival rates compare people with the same type and stage of cancer with those in the general population. For example, if the 5-year relative survival rate for a particular stage of nasopharyngeal cancer is 80%, that means, on average, about 80% of people with that stage live at least 5 years. after being diagnosed.

3.2. Where do these numbers come from? The American Cancer Society relies on information from the SEER (Surveillance, Epidemiology, and End Results) database, provided by the National Cancer Institute for survival statistics. for different types of cancer.
The SEER database tracks 5-year relative survival for nasopharyngeal cancer in the United States, based on how far the cancer has spread. However, the SEER database does not group cancers by AJCC TNM stages (stages 1, 2, 3, etc.) signs that the cancer has spread beyond the oropharynx. Regional: Cancer has spread beyond the nasopharynx to nearby structures or lymph nodes. Distant: Cancer has spread to distant parts of the body, like the lungs or liver. 3.3. 5 year relative survival rates for nasopharyngeal cancer These numbers are based on people diagnosed with oropharyngeal cancer between 2009 and 2016.

3.4. How to understand the numbers These numbers only apply to the stage of cancer when it is first diagnosed, not after the cancer has grown, spread, or recurred after treatment.
These numbers don't tell the whole story. Rates are grouped based on how far the cancer has spread, but other factors, like age and overall health and how well the cancer responds to treatment, can also affect prognosis. sick.
People currently being diagnosed with nasopharyngeal cancer may have a better prognosis than these numbers. Treatments improve over time, and these numbers are based on people diagnosed and treated at least five years earlier.
Nasopharyngeal cancer is a dangerous disease and needs to be detected early. When a patient is found with throat cancer at an early stage, there are many options for treatment. While stage 3 nasopharyngeal cancer or stage 4 nasopharyngeal cancer usually has a poor prognosis. Therefore, you should perform regular health checkups and perform cancer screening when there is a family history of the disease.
Currently, cancers, nasopharyngeal cancer, and late stage nasopharyngeal cancer are on the rise and younger. Therefore, proactively performing oropharyngeal cancer screening as well as periodic health check-ups are very important to prolong life and reduce treatment costs for patients themselves.
With synchronous investment in modern machinery and equipment and a team of doctors and experts from home and abroad, Vinmec International General Hospital has specialized examination services to help detect cancer early. nasopharyngeal, hypopharynx, larynx are the best.
The above examination is recommended to be applied to all subjects over 30 years old as well as customers who need periodic examination to screen for cancer and people with suspicious symptoms. With quality service and in-depth medical care, Vinmec has now become a prestigious address in nasopharyngeal cancer screening that you can completely trust.

Article referenced source: American Cancer Society