Head & neck · 2019
Recategorization of tumor stage in patients with node-negative oral tongue cancer: Impact of the eighth edition American Joint Committee staging system.
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Dang Rushil R, Qureshi Muhammad M, Caldroney Steven J, Salama Andrew R, Truong Minh Tam
Аннотация
BACKGROUND: To evaluate recategorization of pT1-3N0 oral tongue cancer, from seventh to eighth editions of the American Joint Committee on Cancer (AJCC) staging classification, and impact on overall survival (OS).
METHODS: Using the National Cancer Database, 1277 patients were categorized using tumor size and depth of invasion with seventh and eighth AJCC staging systems and evaluated for OS.
RESULTS: Tumor-category was unchanged in 82.9% and upstaged in 17.1% patients with eighth AJCC. The 3-year OS was 85.3%, 76.6%, and 77.0% with seventh AJCC compared to 87.1%, 75.1%, and 81% with eighth AJCC, for patients with pT1N0, pT2N0, and pT3N0 disease, respectively. Improved discrimination of pT1N0 vs pT2N0 for OS on multivariate analysis was seen for eighth AJCC (hazard ratio [HR] = 1.43, 95% confidence interval [CI]: 1.03-1.98, P = .03) but not for patients with pT3N0, with seventh AJCC (HR = 1.02, 95% CI:0.53-1.98, P = .95), and eighth AJCC (HR = 0.86, 95% CI: 0.52-1.42, P = .55).
CONCLUSION: Eighth edition AJCC staging leads to improved discrimination of OS between pT1N0 and pT2N0 but not for patients with pT3N0.
METHODS: Using the National Cancer Database, 1277 patients were categorized using tumor size and depth of invasion with seventh and eighth AJCC staging systems and evaluated for OS.
RESULTS: Tumor-category was unchanged in 82.9% and upstaged in 17.1% patients with eighth AJCC. The 3-year OS was 85.3%, 76.6%, and 77.0% with seventh AJCC compared to 87.1%, 75.1%, and 81% with eighth AJCC, for patients with pT1N0, pT2N0, and pT3N0 disease, respectively. Improved discrimination of pT1N0 vs pT2N0 for OS on multivariate analysis was seen for eighth AJCC (hazard ratio [HR] = 1.43, 95% confidence interval [CI]: 1.03-1.98, P = .03) but not for patients with pT3N0, with seventh AJCC (HR = 1.02, 95% CI:0.53-1.98, P = .95), and eighth AJCC (HR = 0.86, 95% CI: 0.52-1.42, P = .55).
CONCLUSION: Eighth edition AJCC staging leads to improved discrimination of OS between pT1N0 and pT2N0 but not for patients with pT3N0.