# New T staging recommendations for recurrent nasopharyngeal carcinoma

## TL;DR

This study proposes a new T staging system for recurrent nasopharyngeal cancer that better predicts patient survival than the current standard.

## Contribution

A new rT staging system for recurrent nasopharyngeal carcinoma with improved survival prediction.

## Key findings

- The new rT staging system showed better predictive value for survival than the 8th UICC/AJCC staging.
- rT1 and rT2 patients in the new system had significantly different survival outcomes.
- Smoking, family history, and recurrence time were independent prognostic factors for survival.

## Abstract

The International Union for Cancer Control/American Joint Committee on Cancer (UICC/AJCC) rT staging is not clinically practical for recurrent nasopharyngeal carcinoma (rNPC). The aim of this study was to establish a new rT staging to guide the treatment of rNPC.

We conducted a retrospective analysis of 175 patients diagnosed with rNPC between January 2012 and December 2020, using ROC curve analysis to evaluate its effectiveness.

We analyzed the overall survival (OS) and progression-free survival(PFS) of patients diagnosed with rNPC according to the 8th (UICC/AJCC) rT staging, and found that the overall survival of rT1 and rT2 patients (OS; 29.98% vs. 27.09%, p = 0.8059) and progression-free survival (PFS; 28.48% vs. 26.12%, p = 0.4045) had no significant difference. In rT1 and rT2 patients of this study, overall survival(OS; 30.44% vs. 24.91%, p = 0.0229) and progression-free survival(PFS 29.12% vs. 24.03%, p = 0.0459) had a significant difference. Smoking, family history, and time interval of initial recurrence were independent prognostic factors for OS and PFS.

The new rT staging of this study has a better predictive value for survival of rNPC patients than the 8th (UICC/AJCC) rT staging.