Die 9. Ausgabe der TNM-Klassifikation nach UICC
摘要
The TNM system, implemented since 1958, is an established tool for classifying solid tumors and categorizing them based on tumor size and extent, regional lymph node involvement, and the presence of distant metastases. The current 9th edition of the TNM system offers extensive revisions in the head and neck area, with a particular focus on the clinical, radiological, and pathological extracapsular spread of lymph node metastases and the corresponding prognostic relevance.
Materials and methodsThe 9th edition of the TNM classification of the Union for International Cancer Control (UICC) served as the basis for the review. It was published in July 2025 and should be implemented from January 2026. The background to the corresponding changes is explained based on a detailed literature search.
ResultsAs before, revisions to the TNM classification were made particularly for human papillomavirus (HPV)/p16-positive oropharyngeal cancers with regard to extracapsular extension. For nasopharyngeal cancers, there was a modification to the UICC stages due to improved prognostic significance. Specifications were also made for the depth of invasion of oral cavity cancers. Minor salivary gland cancers have now been included in the classification system alongside cancers of major salivary glands.
ConclusionFollowing extensive revisions in the head and neck area, there have been notable changes, particularly in the field of HPV/p16-positive oropharyngeal cancer. The extent to which these changes will prove to be prognostically relevant remains to be seen after the new TNM system has been implemented in clinical routine.