Overcoming “Stage” Fright: American Joint Committee on Cancer 8th Edition Pharyngeal Cancer Update

J.M. Yetto, A. Germana, M.P. Bauer, J.R. Foley, P.A. Moullet, and M.R. Cathey

View Article on Neurographics Website

Date of Activity Release: April 4, 2019
Date of Activity Expiration: April 4, 2022

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objectives:
1) Compare the American Joint Committee on Cancer 7th Edition description of T4 disease versus the 8th edition description of T2 disease for nasopharyngeal carcinoma, 2) explain the relationship between the Epstein-Barr virus and nasopharyngeal carcinoma as well as the human papillomavirus and p16oropharyngeal cancer, and 3) describe the impact of extranodal extension on clinical staging for cervical nodal metastasis in the setting of an unknown primary tumor, as well as for p16 oropharyngeal and hypopharyngeal cancers.

Significant changes to the staging system for pharyngeal cancers are contained within the recently implemented American Joint Committee on Cancer 8th Edition Cancer Staging Manual and reflect current prognoses and treatment options. This article reviews changes particularly relevant to radiologists and highlights the critical role that radiologists play in the diagnosis and staging of head and neck cancer. By using multimodality case examples, nasopharyngeal, oropharyngeal, and hypopharyngeal carcinomas are emphasized as well as the newly described entity of radiologically overt extranodal extension.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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