Nikolaus Moeckelmann1, Ardalan Ebrahimi2, Ying K Tou3, Ruta Gupta4, Tsu-Hui Hubert Low5, Bruce Ashford6, Sydney Ch'ng5, Carsten E Palme5, Jonathan R Clark7. 1. Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Department of Otolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: n.moeckelmann@uke.de. 2. Department of Head and Neck Surgery, Liverpool Hospital, Liverpool, New South Wales, Australia. 3. Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia. 4. Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia. 5. Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia. 6. School of Biological Sciences, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia; Illawarra and Shoalhaven Local Health District (ISLHD), Wollongong, Australia; Centre for Oncology Education and Research Translation (CONCERT), Liverpool, Australia. 7. Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia; South West Clinical School, University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: The American Joint Committee on Cancer (AJCC) has changed the staging system of oral squamous cell carcinoma (OSCC) in the 8th edition of its staging manual to include depth of invasion (DOI) of the primary tumor as a modifier to the T category and extranodal extension (ENE) to upstage node positive OSCC. This study aims to evaluate the performance of the AJCC 8 pathologic staging system in OSCC and compare it to its predecessor (AJCC 7). METHODS: Analysis of 663 patients with OSCC from a prospective database was performed using the Cox proportional hazards competing risk model. The prognostic performance of the pathologic staging system was assessed using the Akaike Information Criterion (AIC) and Harrell's concordance index (C-index). RESULTS: AJCC 8 led to upstaging of 35.6% (N = 235) of patients in this cohort. Both AJCC 7 and 8 show limited monotonicity and poor stratification between stage groups I to III. The estimates for model performance reveal that AJCC 8 has modest predictive capacity for overall survival (OS) and disease specific survival (DSS) (Harrell's C of 0.70 and 0.74, respectively) but is superior to AJCC 7 (Harrell's C of 0.65 and 0.69, respectively). CONCLUSIONS: The AJCC 8 staging system is more complex than its former version due to the inclusion of DOI and ENE. Compared with AJCC 7, it performs better in stratifying survival of OSCC patients by stage.
BACKGROUND: The American Joint Committee on Cancer (AJCC) has changed the staging system of oral squamous cell carcinoma (OSCC) in the 8th edition of its staging manual to include depth of invasion (DOI) of the primary tumor as a modifier to the T category and extranodal extension (ENE) to upstage node positive OSCC. This study aims to evaluate the performance of the AJCC 8 pathologic staging system in OSCC and compare it to its predecessor (AJCC 7). METHODS: Analysis of 663 patients with OSCC from a prospective database was performed using the Cox proportional hazards competing risk model. The prognostic performance of the pathologic staging system was assessed using the Akaike Information Criterion (AIC) and Harrell's concordance index (C-index). RESULTS: AJCC 8 led to upstaging of 35.6% (N = 235) of patients in this cohort. Both AJCC 7 and 8 show limited monotonicity and poor stratification between stage groups I to III. The estimates for model performance reveal that AJCC 8 has modest predictive capacity for overall survival (OS) and disease specific survival (DSS) (Harrell's C of 0.70 and 0.74, respectively) but is superior to AJCC 7 (Harrell's C of 0.65 and 0.69, respectively). CONCLUSIONS: The AJCC 8 staging system is more complex than its former version due to the inclusion of DOI and ENE. Compared with AJCC 7, it performs better in stratifying survival of OSCC patients by stage.
Authors: Angela J Yoon; Shuang Wang; David I Kutler; Richard D Carvajal; Elizabeth Philipone; Tian Wang; Scott M Peters; Dominic LaRoche; Brenda Y Hernandez; Bradley D McDowell; Claire R Stewart; Fatemeh Momen-Heravi; Regina M Santella Journal: Head Neck Date: 2020-01-25 Impact factor: 3.147
Authors: Steven W Mes; Floris H P van Velden; Boris Peltenburg; Carel F W Peeters; Dennis E Te Beest; Mark A van de Wiel; Joost Mekke; Doriene C Mulder; Roland M Martens; Jonas A Castelijns; Frank A Pameijer; Remco de Bree; Ronald Boellaard; C René Leemans; Ruud H Brakenhoff; Pim de Graaf Journal: Eur Radiol Date: 2020-06-04 Impact factor: 5.315
Authors: Giuseppe Troiano; Corrado Rubini; Lucrezia Togni; Vito Carlo Alberto Caponio; Khrystyna Zhurakivska; Andrea Santarelli; Nicola Cirillo; Lorenzo Lo Muzio; Marco Mascitti Journal: Cancer Med Date: 2020-10-13 Impact factor: 4.452