Evolution of the Chinese staging system for nasopharyngeal carcinoma.

The clinical treatment of nasopharyngeal carcinoma (NPC) in China started in 1940s is based on our own clinical staging system. In 1965, we established the first TNM staging system for NPC. Advances in technology and therapy led to continuous updates in clinical staging. Currently, the Chinese staging system of 2008 is commonly used in China. Compared with the 7th edition of the American Joint Committee on Cancer (AJCC) staging system, which is widely used internationally, the N classification was based on magnetic resonance imaging (MRI) as well as the lymph node criteria of the Radiation Therapy Oncology Group (RTOG) consensus guidelines. However, several studies showed that these two staging systems were associated with limitations. Additional international studies from different cancer centers are needed to improve and evolve a universally accepted staging system for NPC.