Dr. Mehanna on Implications of the Updated Staging System for HPV+ Head and Neck Cancer

Hisham Mehanna, PhD, BMedSc, MBChB, FRCS, chair, Head and Neck Surgery director, Institute of Head and Neck Studies and Education at the School of Cancer Studies, University of Birmingham, discusses the implications of the updated staging system for patients with HPV-positive head and neck cancer.

In 2018, 3 changes were made to the staging of head and neck cancer following the release of the eighth edition of the AJCC Cancer Staging Manual. Based on the new system, there are 2 sections: 1 that accounts for staging prior to diagnosis and 1 that accounts for staging following initial treatment.

Previously, the clinical staging system for nodal disease was very similar to the pathologic staging system. Now, these 2 systems are separate entities, explains Mehanna. Adjusting to the newly defined staging system will take time, he adds. It is important to note that even though the stages were reclassified, the treatment should remain the same. If a patient had stage IV disease in the old system and now has stage II disease according to the new system, the patient should remain on the same treatment, concludes Mehanna.