OBJECTIVE: The last edition of the American Joint Committee on Cancer (AJCC eighth) has introduced the depth of infiltration (DOI) as a new prognostic parameter in oral cavity squamous cell carcinomas (OCSCCs). The aim of this study is to analyze the impact of stage migration on the indication to post-operative radiotherapy (PORT). METHODS: OCSCCs treated at two institutions between 2014 and 2019 were retrieved. As per the AJCC eighth, only pT3 primarily OCSCCs were considered; availability of the pathologic specimen was a further inclusion criterion. Risk factors considered for PORT were: pT3-pT4, nodal involvement, positive/close surgical margins, perineural and lymph vascular invasion. RESULTS: 149 patients staged as pT3 AJCC eighth were included. A four-fold increase in the number of patients staged as pT3 from the seventh to the eighth AJCC was found. Stage migration to pT3 was equally due to the downstaging from former pT4 (38%) and upstaging of former pT1-pT2 (35%). Considering the former pT1-pT2 53 patients, 13 (25%) had no risk factors for PORT other than DOI. Among 25 cases with former pT1-pT2 and negative lymph nodes, no additional risk factors were found in 11 (44%). CONCLUSION: 90% of patients had at least one risk factor besides DOI and would have received PORT also according to the AJCC seventh; notably, of former pT1-pT2N0, half of them have been upstaged to pT3 in the current TNM classification. The role of PORT in this cohort of patients has not been clarified yet. ADVANCES IN KNOWLEDGE: Other-than-DOI risk factors leading to PORT indication are highly prevalent in OCSSC patients classified as pT3 per the latest AJCC TNM staging system and should therefore be considered for a comprehensive oncological assessment.
OBJECTIVE: The last edition of the American Joint Committee on Cancer (AJCC eighth) has introduced the depth of infiltration (DOI) as a new prognostic parameter in oral cavity squamous cell carcinomas (OCSCCs). The aim of this study is to analyze the impact of stage migration on the indication to post-operative radiotherapy (PORT). METHODS: OCSCCs treated at two institutions between 2014 and 2019 were retrieved. As per the AJCC eighth, only pT3 primarily OCSCCs were considered; availability of the pathologic specimen was a further inclusion criterion. Risk factors considered for PORT were: pT3-pT4, nodal involvement, positive/close surgical margins, perineural and lymph vascular invasion. RESULTS: 149 patients staged as pT3 AJCC eighth were included. A four-fold increase in the number of patients staged as pT3 from the seventh to the eighth AJCC was found. Stage migration to pT3 was equally due to the downstaging from former pT4 (38%) and upstaging of former pT1-pT2 (35%). Considering the former pT1-pT2 53 patients, 13 (25%) had no risk factors for PORT other than DOI. Among 25 cases with former pT1-pT2 and negative lymph nodes, no additional risk factors were found in 11 (44%). CONCLUSION: 90% of patients had at least one risk factor besides DOI and would have received PORT also according to the AJCC seventh; notably, of former pT1-pT2N0, half of them have been upstaged to pT3 in the current TNM classification. The role of PORT in this cohort of patients has not been clarified yet. ADVANCES IN KNOWLEDGE: Other-than-DOI risk factors leading to PORT indication are highly prevalent in OCSSC patients classified as pT3 per the latest AJCC TNM staging system and should therefore be considered for a comprehensive oncological assessment.
Authors: J S Brown; T K Blackburn; J A Woolgar; D Lowe; R D Errington; E D Vaughan; S N Rogers Journal: Oral Oncol Date: 2006-12-14 Impact factor: 5.337
Authors: Jennifer R Cracchiolo; Bin Xu; Jocelyn C Migliacci; Nora Katabi; David G Pfister; Nancy Y Lee; Snehal G Patel; Ronald A Ghossein; Richard J Wong Journal: Head Neck Date: 2018-03-09 Impact factor: 3.147
Authors: Ivan Toledano; Pierre Graff; Antoine Serre; Pierre Boisselier; René-Jean Bensadoun; Cécile Ortholan; Pascal Pommier; Séverine Racadot; Gilles Calais; Marc Alfonsi; Veronique Favrel; Philippe Giraud; Michel Lapeyre Journal: Radiother Oncol Date: 2012-01-31 Impact factor: 6.280
Authors: Christopher M Nutting; James P Morden; Kevin J Harrington; Teresa Guerrero Urbano; Shreerang A Bhide; Catharine Clark; Elizabeth A Miles; Aisha B Miah; Kate Newbold; MaryAnne Tanay; Fawzi Adab; Sarah J Jefferies; Christopher Scrase; Beng K Yap; Roger P A'Hern; Mark A Sydenham; Marie Emson; Emma Hall Journal: Lancet Oncol Date: 2011-01-12 Impact factor: 41.316
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