{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:51:28Z","timestamp":1793947888685,"version":"4.8.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec id=\"ab-coi240056-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Accurate staging is a fundamental step in treating patients with nasopharyngeal carcinoma (NPC) worldwide; this is crucial not only for prognostication, but also for guiding treatment decisions. The American Joint Committee on Cancer (AJCC)\/Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) system is the global language for clinicians, researchers, and cancer registries. Continual improvement that aligns with contemporary pattern of care is essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi240056-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To improve the prognostic accuracy and clinical applicability of the eighth edition (TNM-8) for NPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi240056-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This multicenter study analyzed patients with NPC with detailed tumor features during January 2014 and December 2015 and was reviewed by experienced radiologists. The data analysis was completed in December 2023. The findings were further confirmed with internal and external validation. Statistical analyses and clinical considerations were reviewed by the AJCC\/UICC multidisciplinary head and neck panels and attained consensus. The recommendations were evaluated by the AJCC Evidence-Based Medicine Committee before final endorsement as the ninth version (TNM-9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi240056-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary end point was overall survival. Adjusted hazard ratios of different subgroups were then assessed for confirmation of optimal stage grouping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi240056-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 4914 patients analyzed, 1264 (25.7%) were female and 3650 (74.3%) were male; the median (SD) age was 48.1 (12.0) years. Advanced radiological extranodal extension (with involvement of adjacent muscles, skin, and\/or neurovascular bundles) was identified as an independent adverse factor for all end points: this was added as a criterion for N3. Patients with nonmetastatic disease were regrouped into stages I to III instead of TNM-8 stages I to IVA. Significant hazard discrimination was achieved by grouping T1-2N0-1 as stage I, T3\/N2 as stage II, and T4\/N3 as stage III. Although the T1-2N0-1 subgroups had comparable 5-year overall survival, subdivisions into IA (T1-T2N0) and IB (T1-T2N1) were recommended due to the distinction in adjusted hazard ratios following adjustment for chemotherapy use. Metastatic disease was exclusively classified as stage IV, and prognostication was further refined by subdivision into IVA (M1a, \u22643 lesions) and IVB (M1b, &amp;amp;gt;3 lesions). TNM-9 demonstrated superiority compared with TNM-8 in major statistical aspects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi240056-9\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>The results of this diagnostic study suggest that the ninth version of TNM staging for NPC, based on robust analyses and a comprehensive review by the AJCC\/UICC staging committees, provides an improved staging system for global application and a framework for future incorporation of nonanatomical factors. This will be launched for global application in January 2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoncol.2024.4354","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T11:01:18Z","timestamp":1728558078000},"page":"1627","source":"Crossref","is-referenced-by-count":145,"title":["Ninth Version of the AJCC and UICC Nasopharyngeal Cancer TNM Staging Classification"],"prefix":"10.1001","volume":"10","author":[{"given":"Jian-Ji","family":"Pan","sequence":"first","affiliation":[{"name":"Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China"},{"name":"Xiamen Humanity Hospital, Fujian Medical University Fujian, China"},{"name":"American Joint Committee on Cancer Expert Panel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Qiang","family":"Mai","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Tong","family":"Ng","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Su","family":"Hu","sequence":"additional","affiliation":[{"name":"Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Gao","family":"Li","sequence":"additional","affiliation":[{"name":"Jiangxi Cancer Hospital and NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma (Jiangxi Cancer Hospital of Nanchang Medical College), Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Zhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C. H.","family":"Chow","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Wong","sequence":"additional","affiliation":[{"name":"Pamela Youde Nethersole Eastern Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Lee","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"},{"name":"The University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Yu","family":"Ma","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao-Juan","family":"Guo","sequence":"additional","affiliation":[{"name":"Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Liu","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Zhi","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Ting","family":"Xu","sequence":"additional","affiliation":[{"name":"Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Chang","family":"Gong","sequence":"additional","affiliation":[{"name":"Jiangxi Cancer Hospital and NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma (Jiangxi Cancer Hospital of Nanchang Medical College), Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Yun","family":"Qiang","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-Hung","family":"Au","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz-Chim","family":"Liu","sequence":"additional","affiliation":[{"name":"Pamela Youde Nethersole Eastern Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Leung","family":"Chiang","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"},{"name":"The University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Ping","family":"Xiao","sequence":"additional","affiliation":[{"name":"Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Jun","family":"Lin","sequence":"additional","affiliation":[{"name":"Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Bin","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan-Shan","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene H. L.","family":"Wong","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin-Quan","family":"Tang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Yuan","family":"Xu","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Zhen","family":"Jia","sequence":"additional","affiliation":[{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Sa","family":"Peng","sequence":"additional","affiliation":[{"name":"Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ping","family":"Hu","sequence":"additional","affiliation":[{"name":"Jiangxi Cancer Hospital and NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma (Jiangxi Cancer Hospital of Nanchang Medical College), Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian-Zhu","family":"Lu","sequence":"additional","affiliation":[{"name":"Jiangxi Cancer Hospital and NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma (Jiangxi Cancer Hospital of Nanchang Medical College), Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai-Neng","family":"Cao","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ma","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Blanchard","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"Union for International Cancer Control Head and Neck Core Group"},{"name":"Department of Radiation Oncology, Universit\u00e9 Paris-Saclay, INSERM U1018 Oncostat, Gustave-Roussy, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Williams","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Glastonbury","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann D.","family":"King","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"The Chinese University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehal G.","family":"Patel","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Head and Neck Core Group"},{"name":"Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja R.","family":"Seethala","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Head and Neck Core Group"},{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Dimitrios","family":"Colevas","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai-Ming","family":"Fan","sequence":"additional","affiliation":[{"name":"China Anti-Cancer Association"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin L. K.","family":"Chua","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"Union for International Cancer Control Head and Neck Core Group"},{"name":"National Cancer Centre Singapore and Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, Ontario, Canada"},{"name":"Union for International Cancer Control Head and Neck Core Group"},{"name":"American Joint Committee on Cancer Head and Neck Core Group"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, Ontario, Canada"},{"name":"Union for International Cancer Control Head and Neck Core Group"},{"name":"American Joint Committee on Cancer Head and Neck Core Group"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Lydiatt","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Head and Neck Core Group"},{"name":"Nebraska Methodist Health System, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne W. M.","family":"Lee","sequence":"additional","affiliation":[{"name":"American Joint Committee on Cancer Expert Panel"},{"name":"The University of Hong Kong\u2013Shenzhen Hospital, Shenzhen, China"},{"name":"Union for International Cancer Control Head and Neck Core Group"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"coi240056r1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"coi240056r2","doi-asserted-by":"publisher","DOI":"10.1177\/17588359231221343","article-title":"Combined pre-treatment and middle-treatment Epstein-Barr virus DNA load contributes to prognostication and treatment modification in nasopharyngeal carcinoma patients.","volume":"16","author":"Lan","year":"2024","journal-title":"Ther Adv Med Oncol"},{"issue":"11","key":"coi240056r3","first-page":"5431","article-title":"The whole-blood Epstein-Barr virus DNA can serve as a valuable molecular marker for diagnosis and prognosis prediction of nasopharyngeal carcinoma.","volume":"13","author":"Zeng","year":"2023","journal-title":"Am J Cancer Res"},{"issue":"7","key":"coi240056r4","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1002\/ijc.31856","article-title":"The addition of pretreatment plasma Epstein-Barr virus DNA into the eighth edition of nasopharyngeal cancer TNM stage classification.","volume":"144","author":"Lee","year":"2019","journal-title":"Int J Cancer"},{"issue":"1","key":"coi240056r5","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1002\/cncr.31741","article-title":"Proposed modifications and incorporation of plasma Epstein-Barr virus DNA improve the TNM staging system for Epstein-Barr virus-related nasopharyngeal carcinoma.","volume":"125","author":"Guo","year":"2019","journal-title":"Cancer"},{"key":"coi240056r6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.703995","article-title":"Prognostic factors for overall survival in nasopharyngeal cancer and implication for TNM staging by UICC: a systematic review of the literature.","volume":"11","author":"Chiang","year":"2021","journal-title":"Front Oncol"},{"issue":"3","key":"coi240056r7","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.ccell.2023.12.020","article-title":"Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma.","volume":"42","author":"Du","year":"2024","journal-title":"Cancer Cell"},{"issue":"7","key":"coi240056r8","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1200\/JCO.20.03237","article-title":"Chemotherapy in combination with radiotherapy for definitive-intent treatment of stage II-IVA nasopharyngeal carcinoma: CSCO and ASCO guideline.","volume":"39","author":"Chen","year":"2021","journal-title":"J Clin Oncol"},{"issue":"4","key":"coi240056r9","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.annonc.2020.12.007","article-title":"Nasopharyngeal carcinoma: ESMO-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up.","volume":"32","author":"Bossi","year":"2021","journal-title":"Ann Oncol"},{"issue":"12","key":"coi240056r11","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/j.oraloncology.2014.09.001","article-title":"Should all nasopharyngeal carcinoma with masticator space involvement be staged as T4?","volume":"50","author":"Sze","year":"2014","journal-title":"Oral Oncol"},{"issue":"4","key":"coi240056r12","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000420","article-title":"The prognosis of nasopharyngeal carcinoma involving masticatory muscles: a retrospective analysis for revising T subclassifications.","volume":"94","author":"Xiao","year":"2015","journal-title":"Medicine (Baltimore)"},{"issue":"20","key":"coi240056r13","doi-asserted-by":"publisher","first-page":"7572","DOI":"10.1002\/cam4.3328","article-title":"Staging of T2 and T3 nasopharyngeal carcinoma: proposed modifications for improving the current AJCC staging system.","volume":"9","author":"Cui","year":"2020","journal-title":"Cancer Med"},{"key":"coi240056r14","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.radonc.2019.01.021","article-title":"Subclassification of skull-base invasion for nasopharyngeal carcinoma using cluster, network and survival analyses: a double-center retrospective investigation.","volume":"134","author":"Li","year":"2019","journal-title":"Radiother Oncol"},{"key":"coi240056r15","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1419676","article-title":"A study of 358 cases of locally advanced nasopharyngeal carcinoma receiving intensity-modulated radiation therapy: improving the seventh edition of the American Joint Committee on Cancer T-Staging System.","volume":"2017","author":"Zhou","year":"2017","journal-title":"Biomed Res Int"},{"key":"coi240056r16","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.oraloncology.2018.11.007","article-title":"Extranodal extension is a criterion for poor outcome in patients with metastatic nodes from cancer of the nasopharynx.","volume":"88","author":"Ai","year":"2019","journal-title":"Oral Oncol"},{"key":"coi240056r17","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.radonc.2021.01.015","article-title":"Unambiguous advanced radiologic extranodal extension determined by MRI predicts worse outcomes in nasopharyngeal carcinoma: Potential improvement for future editions of N category systems.","volume":"157","author":"Mao","year":"2021","journal-title":"Radiother Oncol"},{"key":"coi240056r18","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.radonc.2021.10.018","article-title":"Prognostic importance of radiologic extranodal extension in nasopharyngeal carcinoma treated in a Canadian cohort.","volume":"165","author":"Chin","year":"2021","journal-title":"Radiother Oncol"},{"key":"coi240056r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.110050","article-title":"Radiologic extranodal extension for nodal staging in nasopharyngeal carcinoma.","volume":"191","author":"Ai","year":"2024","journal-title":"Radiother Oncol"},{"key":"coi240056r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.09.030","article-title":"Prognostic value of radiologic extranodal extension and its potential role in future N classification for nasopharyngeal carcinoma.","volume":"99","author":"Lu","year":"2019","journal-title":"Oral Oncol"},{"issue":"3","key":"coi240056r21","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.oraloncology.2014.10.012","article-title":"Impact of intensity-modulated radiotherapy on nasopharyngeal carcinoma: Validation of the 7th edition AJCC staging system.","volume":"51","author":"Zong","year":"2015","journal-title":"Oral Oncol"},{"issue":"12","key":"coi240056r22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0168470","article-title":"Recommendations for updating T and N staging systems for nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy.","volume":"11","author":"Liang","year":"2016","journal-title":"PLoS One"},{"issue":"4","key":"coi240056r23","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/S1470-2045(15)00560-4","article-title":"Development and validation of a staging system for HPV-related oropharyngeal cancer by the International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S): a multicentre cohort study.","volume":"17","author":"O\u2019Sullivan","year":"2016","journal-title":"Lancet Oncol"},{"key":"coi240056r24","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105736","article-title":"Refining TNM-8 M1 categories with anatomic subgroups for previously untreated de novo metastatic nasopharyngeal carcinoma.","volume":"126","author":"Chan","year":"2022","journal-title":"Oral Oncol"},{"issue":"4","key":"coi240056r25","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.4143\/crt.2018.652","article-title":"Subdivision of nasopharyngeal carcinoma patients with bone-only metastasis at diagnosis for prediction of survival and treatment guidance.","volume":"51","author":"Sun","year":"2019","journal-title":"Cancer Res Treat"},{"issue":"1","key":"coi240056r26","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1186\/s12885-021-08246-0","article-title":"Subdivision of de-novo metastatic nasopharyngeal carcinoma based on tumor burden and pretreatment EBV DNA for therapeutic guidance of locoregional radiotherapy.","volume":"21","author":"Yang","year":"2021","journal-title":"BMC Cancer"},{"issue":"1","key":"coi240056r27","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s13014-022-02168-2","article-title":"Proposed prognostic subgroups and facilitated clinical decision-making for additional locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: a retrospective study based on recursive partitioning analysis.","volume":"18","author":"Yao","year":"2023","journal-title":"Radiat Oncol"},{"key":"coi240056r28","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.ejca.2017.02.029","article-title":"Establishment and validation of M1 stage subdivisions for de novo metastatic nasopharyngeal carcinoma to better predict prognosis and guide treatment.","volume":"77","author":"Zou","year":"2017","journal-title":"Eur J Cancer"},{"issue":"4","key":"coi240056r29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.21037\/atm.2020.01.13","article-title":"Establishing M1 stage subdivisions by incorporating radiological features and Epstein-Barr virus DNA for metastatic nasopharyngeal carcinoma.","volume":"8","author":"Zheng","year":"2020","journal-title":"Ann Transl Med"},{"issue":"10","key":"coi240056r30","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/s40880-015-0031-9","article-title":"Subdivision of M category for nasopharyngeal carcinoma with synchronous metastasis: time to expand the M categorization system.","volume":"34","author":"Shen","year":"2015","journal-title":"Chin J Cancer"},{"issue":"2","key":"coi240056r31","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s00432-023-05547-8","article-title":"Nasopharyngeal carcinoma: nationwide trends in subtype-specific incidence and survival over 3 decades in a non-endemic area.","volume":"150","author":"van Velsen","year":"2024","journal-title":"J Cancer Res Clin Oncol"},{"issue":"1","key":"coi240056r32","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jcv.2012.05.017","article-title":"Clinical significance of plasma Epstein-Barr Virus DNA loads in a large cohort of Malaysian patients with nasopharyngeal carcinoma.","volume":"55","author":"Chai","year":"2012","journal-title":"J Clin Virol"},{"key":"coi240056r33","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.oraloncology.2016.06.013","article-title":"Prognostic efficacy of combining tumor volume with Epstein-Barr virus DNA in patients treated with intensity-modulated radiotherapy for nasopharyngeal carcinoma.","volume":"60","author":"Lu","year":"2016","journal-title":"Oral Oncol"},{"issue":"11","key":"coi240056r34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166194","article-title":"Prognostic correlations between ABO blood group and pre-treatment plasma Epstein-Barr virus DNA in patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy.","volume":"11","author":"Peng","year":"2016","journal-title":"PLoS One"},{"issue":"5","key":"coi240056r35","doi-asserted-by":"publisher","first-page":"2888","DOI":"10.3892\/ol.2015.3628","article-title":"Levels of plasma Epstein-Barr virus DNA prior and subsequent to treatment predicts the prognosis of nasopharyngeal carcinoma.","volume":"10","author":"Zhao","year":"2015","journal-title":"Oncol Lett"},{"issue":"17","key":"coi240056r36","doi-asserted-by":"publisher","first-page":"24208","DOI":"10.18632\/oncotarget.8144","article-title":"Survival analysis of patients with advanced-stage nasopharyngeal carcinoma according to the Epstein-Barr virus status.","volume":"7","author":"Peng","year":"2016","journal-title":"Oncotarget"},{"issue":"8","key":"coi240056r37","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1038\/s41416-019-0575-6","article-title":"Negative plasma Epstein-Barr virus DNA nasopharyngeal carcinoma in an endemic region and its influence on liquid biopsy screening programmes.","volume":"121","author":"Nicholls","year":"2019","journal-title":"Br J Cancer"},{"key":"coi240056r10","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-3027-2","volume-title":"Recursive Partitioning in the Health Sciences","author":"Heping Zhang","year":"1999","edition":"1st ed"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2824837\/jamaoncology_pan_2024_oi_240056_1734561031.59602.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T11:03:44Z","timestamp":1734606224000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2824837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2024.4354","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}