A proposed modification of the Ho stage-classification for nasopharyngeal carcinoma

Based on the clinical data of a retrospective study of 659 patients with routine computed tomography of the nasopharyngeal region, a refine-ment of Ho's stage-classification for NPC is proposed with reduction in the number of overall stages without sacrificing the accuracy in pre-dicting prognosis in short term. Classifying the cervical lymph nodal metastasis into supra-clavicular (Ho's N3) and above supra-clavicular (Ho's N1+N2) and the nasopharyngeal primary into early (Ho's N1+N2n +T2o) and advanced (HO's T2p+T3+T3p) forms the conceptual back-bone of the present proposed modification of the original Ho stage-classification. Power in predicting the occurrence of distant metastases and the local failures has been enhanced by the proposed T-stage and N-stage re-grouping. Retrospective comparison between Ho's and the UICC stage-classifications showed a more even patients number distribution among the overall stages and a greater power in predicting NPC prognosis for the former. Prospective studies to compare the value of the different stage-classifications are required for recommendation of a single classification for general acceptance to facilitate comparison of treatment results between centres. (author). 24 refs.; 9 figs.; 3 tabs