Veranderingen in de TNM-classificatie van hoofd-halstumoren: Een nieuwe editie

The TNM-classification of the UICC and AJCC is used for staging malignant tumours worldwide. From 2010 the new revised seventh edition must be used. In comparison with the fifth edition there are some specific alterations foor the head and neck. The terms "resectable" and "unresectable" are replaced with "moderately advanced" and "very advanced". In case of lymph node metastases a designation of "U" or "L" may be used to indicate metastases above (U) or below (L) the border of the cricoid. Extracapsular spread (ECS) of lymph node metastases is added as ECS+ or ECS- as a clinical/radiological descriptor. If histopathological examination is available gross ECS (Eg) is apparent to the naked eye, microscopic ECS (Em) as only visualized using a microscope and no ECS (En) as absence of extranodal extension. To reflect the prognostic implication of parapharyngeal extension in nasopharyngeal carcinoma, tumors which only extend to the nasal cavity or oropharynx are now designated T1 instead of T2a, while tumors with extension in the parapharyngeal space are now designated T2 in stead of T2b. In nasopharyngeal carcinoma retropharyngeal lymph node(s), regardless of unilateral or bilateral location is considered Ni. A new chapter for mucosal melanoma of the head and neck is added.