Olgun Elicin1, Martina A Broglie2,3, Niklaus Fankhauser4, Sandro J Stoeckli2, Philippe Pasche5, Antoine Reinhard5, Massimo Bongiovanni6, Gerhard F Huber2,3, Grégoire B Morand3, Alex Soltermann7, Andreas Arnold8, Matthias S Dettmer9, André Arnoux10, Edouard Stauffer11, Vittoria Espeli12, Francesco Martucci13, Daniel M Aebersold1, Roland Giger8. 1. Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland. 3. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. 4. CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. 5. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland. 6. Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland. 7. Institute of Surgical Pathology, University Hospital of Zurich, Zurich, Switzerland. 8. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland. 9. Institute of Pathology, University of Bern, Bern, Switzerland. 10. Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Aarau, Aarau, Switzerland. 11. Institute of Pathology, Promed SA, Fribourg, Switzerland. 12. Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland. 13. Department of Radiooncology, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
Abstract
BACKGROUND: Between the publication of the Union of International Cancer Control staging system (UICC) 7th and 8th editions, other staging algorithms for oropharyngeal squamous cell carcinoma (OPSCC) were proposed from Radiation Therapy Oncology Group (RTOG), MD Anderson Cancer Center (MDACC), and Yale University. METHODS: With C-statistics, the above-mentioned five staging algorithms were compared for overall and relapse-free survival endpoints in a multi-institutional cohort of OPSCC cases (n = 338) treated with primary surgery. RESULTS: Pathological UICC 8th ed yielded the highest C-indexes in the entire cohort and in the HPV- subset, whereas MDACC was superior for HPV+ OPSCC. RTOG was the simplest and holistic algorithm with a noninferior discriminatory power. CONCLUSION: UICC 8th ed, MDACC, and RTOG offer moderate and comparable efficacy for staging in this OPSCC patient cohort undergoing surgical treatment. Notable discrepancy between clinical and pathological UICC 8th ed algorithms poses potential concerns in diagnosis, treatment, research, and data management.
BACKGROUND: Between the publication of the Union of International Cancer Control staging system (UICC) 7th and 8th editions, other staging algorithms for oropharyngeal squamous cell carcinoma (OPSCC) were proposed from Radiation Therapy Oncology Group (RTOG), MD Anderson Cancer Center (MDACC), and Yale University. METHODS: With C-statistics, the above-mentioned five staging algorithms were compared for overall and relapse-free survival endpoints in a multi-institutional cohort of OPSCC cases (n = 338) treated with primary surgery. RESULTS: Pathological UICC 8th ed yielded the highest C-indexes in the entire cohort and in the HPV- subset, whereas MDACC was superior for HPV+ OPSCC. RTOG was the simplest and holistic algorithm with a noninferior discriminatory power. CONCLUSION: UICC 8th ed, MDACC, and RTOG offer moderate and comparable efficacy for staging in this OPSCC patient cohort undergoing surgical treatment. Notable discrepancy between clinical and pathological UICC 8th ed algorithms poses potential concerns in diagnosis, treatment, research, and data management.