Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer

Moran Amit; Samantha Tam; Hideaki Takahashi; Karen Y. Choi; Mark Zafereo; Diana Bell; Randal S. Weber

doi:10.1002/hed.25553

Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer

Moran Amit, Samantha Tam, Hideaki Takahashi, Karen Y. Choi, Mark Zafereo, Diana Bell, Randal S. Weber

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Background: The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC). Methods: Overall survival (OS) and disease-specific survival (DSS) of 244 patients were calculated using the Kaplan-Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression. Results: Sixty-two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition. Conclusion: The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.

Original language	English (US)
Pages (from-to)	1270-1276
Number of pages	7
Journal	Head and Neck
Volume	41
Issue number	5
DOIs	https://doi.org/10.1002/hed.25553
State	Published - May 2019

Keywords

AJCC
depth of invasion
extra nodal extension
oral cavity
staging

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.25553

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title = "Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer",

abstract = "Background: The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC). Methods: Overall survival (OS) and disease-specific survival (DSS) of 244 patients were calculated using the Kaplan-Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression. Results: Sixty-two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition. Conclusion: The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.",

keywords = "AJCC, depth of invasion, extra nodal extension, oral cavity, staging",

author = "Moran Amit and Samantha Tam and Hideaki Takahashi and Choi, {Karen Y.} and Mark Zafereo and Diana Bell and Weber, {Randal S.}",

note = "Funding Information: This study was supported by the National Cancer Institute/ National Institutes of Health (NIH/NCI) under award number P30CA016672 (used the Clinical Trials Support Resource). Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2019",

month = may,

doi = "10.1002/hed.25553",

language = "English (US)",

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AU - Amit, Moran

AU - Tam, Samantha

AU - Takahashi, Hideaki

AU - Choi, Karen Y.

AU - Zafereo, Mark

AU - Bell, Diana

AU - Weber, Randal S.

N1 - Funding Information: This study was supported by the National Cancer Institute/ National Institutes of Health (NIH/NCI) under award number P30CA016672 (used the Clinical Trials Support Resource). Publisher Copyright: © 2018 Wiley Periodicals, Inc.

PY - 2019/5

Y1 - 2019/5

N2 - Background: The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC). Methods: Overall survival (OS) and disease-specific survival (DSS) of 244 patients were calculated using the Kaplan-Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression. Results: Sixty-two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition. Conclusion: The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.

AB - Background: The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC). Methods: Overall survival (OS) and disease-specific survival (DSS) of 244 patients were calculated using the Kaplan-Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression. Results: Sixty-two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition. Conclusion: The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.

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Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer

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