{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:56:22Z","timestamp":1791262582015,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100018537","name":"National Science and Technology Major Project","doi-asserted-by":"publisher","award":["2025ZD0544204"],"award-info":[{"award-number":["2025ZD0544204"]}],"id":[{"id":"10.13039\/501100018537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012547","name":"Natural Science Foundation of Guangxi Zhuang Autonomous Region","doi-asserted-by":"publisher","award":["2023GXNSFAA026147"],"award-info":[{"award-number":["2023GXNSFAA026147"]}],"id":[{"id":"10.13039\/100012547","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate and compare the prognostic value of the 8th and 9th editions of the American Joint Committee on Cancer (AJCC)\/Union for International Cancer Control (UICC) staging system in patients with non\u2010metastatic nasopharyngeal carcinoma (NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data from 470 patients with NPC treated between November 2019 and June 2022 were retrospectively analyzed. Patients were restaged according to the 8th and 9th editions of the AJCC\/UICC staging system. OS was the primary endpoint; locoregional recurrence\u2013free survival (LRFS), distant metastasis\u2013free survival (DMFS), and disease\u2010free survival (DFS) were secondary endpoints. Kaplan\u2013Meier curves were compared using global and pairwise log\u2010rank tests. Prognostic discriminative ability was evaluated using the concordance index (C\u2010index) and Akaike information criterion (AIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen patients (3.6%) classified as T3 by TNM\u20108 were reclassified as T4 by TNM\u20109. Thirty\u2010one patients (6.6%) were reclassified to N3 because of advanced iENE. TNM\u20109 improved discrimination for DMFS across N categories (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 vs.\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016 for TNM\u20108) and for OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 vs.\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042). T categories discriminated LRFS in both editions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012 for each), whereas OS differences were not significant (TNM\u20108\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.139; TNM\u20109\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.137). TNM\u20109 overall stage discriminated OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), unlike TNM\u20108 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.121). Both editions discriminated DFS (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), but TNM\u20109 provided better pairwise separation between early and advanced overall stages. The 9th edition exhibited enhanced predictive performance compared with the 8th edition, as evidenced by higher C\u2010index values and lower Akaike information criterion (AIC) values for both DFS and OS prediction across overall stages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 9th edition of the AJCC\/UICC staging system demonstrated superior prognostic discriminative ability compared with the 8th edition, enabling more accurate risk stratification and supporting more informed clinical decision\u2010making for patients with NPC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72303","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:07:09Z","timestamp":1789956429000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the 9th Edition of the Tumor\u2010Node\u2010Metastasis Staging System for Non\u2010Metastatic Nasopharyngeal Carcinoma: A Multicenter Retrospective Analysis From High\u2010Incidence Regions"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7068-1862","authenticated-orcid":false,"given":"Yongquan","family":"Wei","sequence":"first","affiliation":[{"name":"Youjiang Medical University for Nationalities  Baise Guangxi China"},{"name":"Department of Otolaryngology &amp; Head and Neck The People's Hospital of Guangxi Zhuang Autonomous Region  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danxue","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; Head and Neck The People's Hospital of Guangxi Zhuang Autonomous Region  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoqing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Tenth Affiliated Hospital of Guangxi Medical University  Qinzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Oncology The Wuzhou Red Cross Hospital  Wuzhou Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianxian","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology &amp; Head and Neck The People's Hospital of Guangxi Zhuang Autonomous Region  Nanning 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