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Abstract：
In 1977, the American Joint Committee on Cancer (AJCC) introduced the inaugural Cancer Staging Manual, which implemented the T (tumor extent), N (regional lymph node status), and M (presence or absence of distant metastasis) staging system. This systematic approach aimed to convey the extent of disease across various cancer types, providing clinicians with a practical framework to plan treatment strategies, predict prognosis, and assess outcomes. The AJCC 8th edition, effective from January 1, 2018, continues this tradition. However, certain shortcomings persist in the AJCC 8th edition, as identified through clinical experience. Specifically, challenges arise in accurately assessing depth of invasion in unique histological variants of oral squamous cell carcinoma (e.g., Oral verrucous carcinoma, Carcinoma cuniculatum, and Papillary squamous cell carcinoma) and minor salivary gland tumors. Additionally, discrepancies exist in the perception of bone invasion patterns and in reporting practices. There is also a need for staging guidelines for malignant odontogenic tumors and multifocal tumors of the oral cavity, supplemented by diagrammatic representations. Lastly, there is a call for comprehensive staging criteria for carcinomas of the ear, external auditory canal, and temporal bone. We advocate for the inclusion of these considerations in future editions of the AJCC Cancer Staging Manual.
摘要：
1977年，美国癌症联合委员会（AJCC）推出了首届癌症分期手册，它实现了T(肿瘤程度)，N（区域淋巴结状态），和M（是否存在远处转移）分期系统。这种系统的方法旨在传达各种癌症类型的疾病程度，为临床医生提供一个切实可行的框架来规划治疗策略，预测预后，并评估结果。AJCC第8版，自2018年1月1日起生效，延续了这一传统。然而,AJCC第8版仍然存在某些缺点，通过临床经验确定。具体来说,在准确评估口腔鳞状细胞癌独特组织学变体的侵袭深度方面出现了挑战(例如，口腔疣状癌，cuniculatum,和乳头状鳞状细胞癌）和少量唾液腺肿瘤。此外,骨侵入模式的感知和报告实践中存在差异。还需要针对恶性牙源性肿瘤和口腔多灶性肿瘤的分期指南，以图解表示补充。最后,有人呼吁对耳癌进行全面的分期标准，外耳道,和颞骨。我们主张将这些考虑因素纳入AJCC癌症分期手册的未来版本中。
