Hospital-Based Registry Analysis of Staging Efficacy and Proposed Staging Subclassification for Stage I HPV-Associated Oropharyngeal Squamous Cell Carcinoma

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-03-11 DOI:10.1016/j.oraloncology.2025.107251

F.Jeffrey Lorenz , Michael Kharouta , Sean S. Mahase , Neerav Goyal , Rod Rezaee , Pierre Lavertu , Michell Machtay , Min Yao

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引用次数: 0

Abstract

Objectives

AJCC8 introduced separate staging for HPV-associated OPSCC in 2018 to enhance prognostic discrimination. Consequently, most patients previously staged I-IVA in AJCC7 were reclassified as stage I. This study aimed to stratify AJCC8 stage I HPV-associated OPSCC patients using AJCC7 criteria to assess hazard consistency.

Materials and Methods

The NCDB was queried for patients diagnosed with AJCC7 T1-2 N0-2b HPV-associated OPSCC during 2010–2016 who met criteria to be restaged to AJCC8 overall stage I. Cox-proportional hazards models including AJCC7 T and N stage as covariates were generated to test for significant predictors of 5-year overall survival in patients with stage I disease according to AJCC8, which were then used to generate substages.

Results

A total of 5,737 patients with AJCC7 cT1-2 N0-2b HPV-associated OPSCC were identified. A multivariable Cox-proportional hazards model showed a significant association of cT2 (HR, 95 % CI, P) (1.8, 1.4–2.2, P < 0.001) compared to cT1, and cN2b (1.4, 1.1–1.7, P = 0.002) compared to less than cN2b (i.e. cN0, cN1, cN2a) with 5-year OS. These results were used to generate substages of AJCC8 stage I: cT1N0-2a were designated stage IA, cT2N0-2a and cT1N2b as stage IB, and cT2N2b as stage IIA. Log-rank testing between these substages revealed significant differences between the respective survival curves at 5 years (P < 0.001 for all comparisons).

Conclusion

Substaging of AJCC8 stage I for HPV-associated OPSCC by cT2 and cN2b (7th edition TNM stage) provided significant hazard consistency. Adoption may improve prognostic risk stratification and inform guidance in treatment decision making. Further validation of this staging is warranted.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.