Proposed Version Nine of the AJCC and UICC TNM Classification for Salivary Gland Carcinoma

How can tumor-node-metastasis (TNM) staging for salivary gland carcinoma (SGC) be improved in preparation for version nine of the American Joint Committee on Cancer/Union for International Cancer Control TNM staging protocol?This prognostic study of 9860 patients with surgically treated major SGC developed and validated an SGC-specific pTNM staging. The proposed pN classification (pN0: none; pN1: 1 to 3 positive lymph nodes and extranodal extension negative; pN2: more than 3 positive LNs or extranodal extension positive) and stage group (I: T1N0; II: T2N0; IIIA: T1-2N1/T3-4N0; IIIB: T1-2N2/T3-4N1-N2; IV: M1) improved outcome prediction, aligned with World Health Organization histologic risk groups, and was applicable to both major and minor SGCs.This unified staging system for all SGCs offers improved prognostic accuracy, simplicity, and clinical utility.

Corresponding Authors: Ian Ganly, MD, PhD, Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (ganlyi@mskcc.org); Shao Hui Huang, MD, MSc, MRT(T), Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, 610 University Ave, Toronto, ON M5G 2M9, Canada (shaohui.huang@uhn.ca).

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