BACKGROUND: Half of the patients with head and neck squamous cell carcinoma (HNSCC) can be expected to fail therapy, indicating that more aggressive treatment is warranted for this group. We have developed a novel risk model that can become a basis for developing new treatment paradigms. Here we report on the performance of our model in a new multicenter cohort. DESIGN: Eligible patients from 3 institutions (Montefiore Medical Center, University of Manitoba, and New York University Medical Center) were identified and pathology slides from their resection specimens were reviewed by Margaret Brandwein-Gensler; risk category was assigned as previously published. Kaplan-Meier analysis was performed for disease progression and survival. Cox proportional hazards regression was performed, adjusted for potential confounders. A teaching module was also developed; attending pathologists were asked to score coded slides after a lecture and multiheaded microscope teaching session. Agreement was assessed by calculating Cohen unweighted kappa coefficients. RESULT: The validation cohort consisted of 305 patients, from the above institutions, with 311 primary HNSCC of the oral cavity, oropharynx, and larynx. The median follow-up period for all patients was 27 months. Risk category predicts time to disease progression (P=0.0005), locoregional recurrence (P=0.013), and overall survival (P=0.0000) by Kaplan-Meier analysis. High-risk status is significantly associated with decreased time to disease progression, adjusted for clinical confounders (P=0.015, hazard ratio 2.32, 95% confidence interval 1.18-4.58) compared with collapsed intermediate and low-risk groups. We also demonstrate substantial interrater agreement (kappa=0.64), and very good rater agreement when compared with the standard (kappa=0.87). CONCLUSIONS: We demonstrate significant predictive performance of the risk model in a new cohort of patients with primary HNSCC, adjusted for confounders. Our training experience also supports the feasibility of adapting the risk model in clinical practice.
BACKGROUND: Half of the patients with head and neck squamous cell carcinoma (HNSCC) can be expected to fail therapy, indicating that more aggressive treatment is warranted for this group. We have developed a novel risk model that can become a basis for developing new treatment paradigms. Here we report on the performance of our model in a new multicenter cohort. DESIGN: Eligible patients from 3 institutions (Montefiore Medical Center, University of Manitoba, and New York University Medical Center) were identified and pathology slides from their resection specimens were reviewed by Margaret Brandwein-Gensler; risk category was assigned as previously published. Kaplan-Meier analysis was performed for disease progression and survival. Cox proportional hazards regression was performed, adjusted for potential confounders. A teaching module was also developed; attending pathologists were asked to score coded slides after a lecture and multiheaded microscope teaching session. Agreement was assessed by calculating Cohen unweighted kappa coefficients. RESULT: The validation cohort consisted of 305 patients, from the above institutions, with 311 primary HNSCC of the oral cavity, oropharynx, and larynx. The median follow-up period for all patients was 27 months. Risk category predicts time to disease progression (P=0.0005), locoregional recurrence (P=0.013), and overall survival (P=0.0000) by Kaplan-Meier analysis. High-risk status is significantly associated with decreased time to disease progression, adjusted for clinical confounders (P=0.015, hazard ratio 2.32, 95% confidence interval 1.18-4.58) compared with collapsed intermediate and low-risk groups. We also demonstrate substantial interrater agreement (kappa=0.64), and very good rater agreement when compared with the standard (kappa=0.87). CONCLUSIONS: We demonstrate significant predictive performance of the risk model in a new cohort of patients with primary HNSCC, adjusted for confounders. Our training experience also supports the feasibility of adapting the risk model in clinical practice.
Authors: Cheng Lu; James S Lewis; William D Dupont; W Dale Plummer; Andrew Janowczyk; Anant Madabhushi Journal: Mod Pathol Date: 2017-08-04 Impact factor: 7.842
Authors: Alhadi Almangush; Ibrahim O Bello; Ricardo D Coletta; Antti A Mäkitie; Laura K Mäkinen; Joonas H Kauppila; Matti Pukkila; Jaana Hagström; Jussi Laranne; Ylermi Soini; Veli-Matti Kosma; Petri Koivunen; Natalie Kelner; Luiz Paulo Kowalski; Reidar Grénman; Ilmo Leivo; Esa Läärä; Tuula Salo Journal: Virchows Arch Date: 2015-04-03 Impact factor: 4.064
Authors: Marisa R Buchakjian; Timothy Ginader; Kendall K Tasche; Nitin A Pagedar; Brian J Smith; Steven M Sperry Journal: Otolaryngol Head Neck Surg Date: 2018-05-08 Impact factor: 3.497
Authors: Gregory T Wolf; William Winter; Emily Bellile; Ariane Nguyen; C R Donnelly; Jonathan B McHugh; Dafydd Thomas; Lahin Amlani; Laura Rozek; Yu L Lei Journal: Oral Oncol Date: 2018-10-22 Impact factor: 5.337
Authors: Namita Sinha; Matthew H Rigby; Michael L McNeil; S Mark Taylor; Jonathan Rb Trites; Robert D Hart; Martin J Bullock Journal: Mod Pathol Date: 2018-02-02 Impact factor: 7.842
Authors: Parul Sinha; Mitra Mehrad; Rebecca D Chernock; James S Lewis; Samir K El-Mofty; Ningying Wu; Brian Nussenbaum; Bruce H Haughey Journal: Head Neck Date: 2014-01-16 Impact factor: 3.147
Authors: Yufeng Li; Shuting Bai; William Carroll; Dan Dayan; Joseph C Dort; Keith Heller; George Jour; Harold Lau; Carla Penner; Michael Prystowsky; Eben Rosenthal; Nicolas F Schlecht; Richard V Smith; Mark Urken; Marilena Vered; Beverly Wang; Bruce Wenig; Abdissa Negassa; Margaret Brandwein-Gensler Journal: Head Neck Pathol Date: 2012-12-19
Authors: G Tirelli; S Zacchigna; F Boscolo Nata; E Quatela; R Di Lenarda; M Piovesana Journal: Eur Arch Otorhinolaryngol Date: 2016-08-04 Impact factor: 2.503