[Comment for the Chinese 2008 staging system for nasopharyngeal carcinoma]

The advantages of the Chinese 2008 staging system for nasopharyngeal carcinoma included as follows: 1.Application of MRI as the major staging means; discard of the subjective factors. 2.Adoption of some new independent predictor such as metastatic retropharyngeal lymph nodes and RTOG cervical levels. 3.Simplification of the T category. 4.Categorization of N and clinical substage can distinct the risk of distant metastasis and overall survival. All these changes adapted to the modern diagnosis and treatment pattern with a higher degree of practicality. Therefore, developing a prospective, multicenter clinical verification of the existing standards, thereby correcting itself, fulfill the developmental and scientific principles. It may improve as follows: 1.The definition of anatomical structure is restrictive such as nasal cavity and oropharynx, and the expression of masticator space is not intuitive. 2.Proof of evidence-based medicine for the size of lymph nodes included in the N category is insufficient. 3.The risk of local recurrence between the subgroups of T category was not significant. 4.Different definition of the index such as oropharynx and cervical level between the sixth edition UICC / AJCC staging system and the current system will hinder the international exchange of experience and information.