In the beginning of 2017, the 8th edition of the TNM classification of malignant tumors
has been available. The classification for head and neck carcinoma regarding the p16-Expression
changed.
However, the situation is unclear when the primary tumor and local lymph node metastasis
shows a different expression of p16.
We introduce a patient with oropharyngeal carcinoma and ipsilateral cervical metastasis.
After tumorextraction and selective neck dissection on both sides, the histological
result shows a p-16 positivity in the primary tumor, but this expression was not detected
in the cervical lymph nodes. There was no evidence of a second carcinoma during the
staging examination.
Using the 8th edition of the outgoing TNM classification, the classification of p16-positiv
tumors has to be pT2, pN1, V0, R0 (UICC Stadium III) and for the p16-negative pT2,
pN2a, V0, R0 (UICC stage IVa).
The question now arises which of the two named TNM classifications should be used
in this case.
