Palatoglossus Muscle and T4 Category in the Eighth Edition of TNM Staging System for OPSCC.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Giancarlo Tirelli, Nicoletta Gardenal, Jerry Polesel, Jasmina De Groodt, Erik Radin, Fabiola Giudici, Laura Iandolo, Simone Zucchini, Egidio Sia, Paolo Boscolo-Rizzo
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引用次数: 0

Abstract

Objective: The present study challenges the appropriateness of considering invasion of the palatoglossus muscle (PGM) as a criterion for staging oropharyngeal squamous cell carcinoma (OPSCC) as T4.

Study design: Retrospective observational study.

Setting: Tertiary University Hospital.

Methods: This retrospective study included nonmetastatic OPSCC patients treated with curative intent at the University of Trieste, Italy from 2015 to 2021. Patients were categorized into 4 groups: (1) tumors classified as T1-T2 by both International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC)-TNM; (2) T1-T2 tumors upgraded to T4 solely by UICC due to oropharyngeal PGM infiltration; (3) T1-T2 tumors upgraded to T4 by both UICC and AJCC due to oral PGM infiltration; (4) tumors classified as T3-T4 by both UICC and AJCC. Kaplan-Meier analysis estimated overall survival (OS) and disease-free survival (DFS). Multivariable Cox models, adjusted for clinical factors, assessed the impact of palatoglossus invasion on outcomes over 5 years.

Results: A total of 121 consecutive patients with primary OPSCC were included (median [interquartile range] age 65 years [58-74]; 63% male). While patients with upgraded T4 category due to infiltration of the oral portion of the PGM exhibited a prognosis superimposable on that of other patients with advanced stage disease, those with upgraded T4 category due to infiltration of the oropharyngeal portion of the PGM displayed OS and DFS comparable to T1-T2 patients.

Conclusion: Our findings highlight that invasion of the oropharyngeal portion of the PGM may not be a suitable criterion for staging OPSCC as T4. Further research involving larger and independent patient cohorts is strongly encouraged to corroborate these observations.

腭舌肌与第八版 OPSCC TNM 分期系统中的 T4 类别。
研究目的本研究对将侵犯腭舌肌(PGM)作为口咽鳞癌(OPSCC)T4分期标准的适当性提出质疑:研究设计:回顾性观察研究:研究方法:回顾性观察研究:这项回顾性研究纳入了2015年至2021年在意大利的里雅斯特大学接受治愈性治疗的非转移性OPSCC患者。患者被分为4组:(1)被国际癌症控制中心(UICC)和美国癌症联合委员会(AJCC)-TNM归为T1-T2的肿瘤;(2)因口咽PGM浸润而被UICC升级为T4的T1-T2肿瘤;(3)因口腔PGM浸润而被UICC和AJCC升级为T4的T1-T2肿瘤;(4)被UICC和AJCC归为T3-T4的肿瘤。Kaplan-Meier 分析估计了总生存期(OS)和无病生存期(DFS)。经临床因素调整的多变量考克斯模型评估了腭舌骨受侵对5年生存率的影响:共纳入了121例原发性OPSCC患者(中位数[四分位之间]年龄为65岁[58-74岁];63%为男性)。因PGM口腔部分浸润而升级为T4类的患者与其他晚期患者的预后相似,而因PGM口咽部分浸润而升级为T4类的患者的OS和DFS与T1-T2类患者相当:我们的研究结果表明,PGM口咽部浸润可能不是将OPSCC分期为T4的合适标准。我们强烈建议对更大规模的独立患者群体进行进一步研究,以证实这些观察结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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