A Proposal for HPV-Associated Oropharyngeal Carcinoma in the Ninth Edition Clinical TNM Classification

Shao Hui Huang, Jie Su, Shlomo A. Koyfman, David M. Routman, Frank Hoebers, Houda Bahig, Eugene Yu, Eric Bartlett, Anna Spreafico, Jonathan Lee, Sarah J. Stock, Robin L. Davis, N.M. Woody, Kristoff Nelson, Danny Lavigne, Phuc Félix Nguyen‐Tan, Laurent Létourneau‐Guillon, Édith Filion, Alex A. Nagelschneider, J. Daniel, Kathryn M. Van Abel, Alida A. Postma, Walter M. Palm, Ann Hoeben, William M. Lydiatt, Snehal G. Patel, Melvin L.K. Chua, Wei Xu, Brian O’Sullivan

In this study, reclassifying each N category 1 stratum higher for iENE-positive disease resulted in better disease-free and overall survival. The proposed new classification outperformed the currently TNM staging system in risk stratification and may facilitate future clinical trial design, outcomes research, and patient care.