Ardalan Ebrahimi1,2,3, Ziv Gil4,5, Moran Amit4,5, Tzu-Chen Yen6, Chun-Ta Liao6, Pankaj Chatturvedi7, Jaiprakash Agarwal7, Luiz Kowalski8, Matthias Kreppel9, Claudio Cernea10, Jose Brandao10, Gideon Bachar11, Andrea Bolzoni Villaret12, Dan Fliss13, Eran Fridman13, K Thomas Robbins14, Jatin Shah15, Snehal Patel15, Jonathan Clark1,2. 1. Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. 2. Department of Head and Neck Surgery, Liverpool Hospital, Sydney, New South Wales, Australia. 3. University of New South Wales, Sydney, New South Wales, Australia. 4. The Laboratory for Applied Cancer Research, the Technion, Israel Institute of Technology, Haifa, Israel. 5. Department of Otolaryngology, Rambam Medical Center, Rappaport School of Medicine, the Technion, Israel Institute of Technology, Haifa, Israel. 6. Chang Gung Memorial Hospital, Taoyuan, Taiwan. 7. Tata Memorial Hospital, Mumbai, India. 8. Hospital A.C. Camargo, São Paulo, Brazil. 9. Department of Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Cologne, Germany. 10. Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil. 11. Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel. 12. Department of ENT, University of Brescia, Brescia, Italy. 13. Department of Otolaryngology Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel. 14. Southern Illinois University School of Medicine, Carbondale, Illinois. 15. Head and Neck Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
Abstract
BACKGROUND: We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. METHODS: An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. RESULTS: Univariate analysis revealed no difference in locoregional failure (p = .184), DSS (p = .761), or OS (p = .475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. CONCLUSION: The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.
BACKGROUND: We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. METHODS: An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. RESULTS: Univariate analysis revealed no difference in locoregional failure (p = .184), DSS (p = .761), or OS (p = .475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. CONCLUSION: The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.
Authors: Matthias Kreppel; Uta Drebber; Daniel Rothamel; Hans-Theodor Eich; Alexander Kübler; Martin Scheer; Joachim E Zöller Journal: Head Neck Date: 2010-11-29 Impact factor: 3.147
Authors: Kapila Manikantan; Suhail I Sayed; Konstantinos N Syrigos; Peter Rhys-Evans; Chris M Nutting; Kevin J Harrington; Rehan Kazi Journal: Cancer Treat Rev Date: 2009-08-22 Impact factor: 12.111
Authors: Eran Fridman; Shorook Na'ara; Jaiprakash Agarwal; Moran Amit; Gideon Bachar; Andrea Bolzoni Villaret; Jose Brandao; Claudio R Cernea; Pankaj Chaturvedi; Jonathan Clark; Ardalan Ebrahimi; Dan M Fliss; Sashikanth Jonnalagadda; Hugo F Kohler; Luiz P Kowalski; Matthias Kreppel; Chun-Ta Liao; Snehal G Patel; Rajan S Patel; K Thomas Robbins; Jatin P Shah; Thomas Shpitzer; Tzu-Chen Yen; Joachim E Zöller; Ziv Gil Journal: Cancer Date: 2018-05-14 Impact factor: 6.860