Comparing the 7th and 8th Editions of AJCC Staging System for Hypopharyngeal Cancer Undergoing Surgery.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-21 DOI:10.1002/ohn.1311

Heng-Yu Haley Lin, Chia-Fan Chang, Tsung-Lun Lee, Yen-Bin Hsu, Shyh-Kuan Tai, Muh-Hwa Yang, Ling-Wei Wang, Pen-Yuan Chu

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引用次数: 0

Abstract

Objective: The prognostic accuracy of the American Joint Committee on Cancer (AJCC) 8th staging system for hypopharyngeal cancer remains uncertain. We aim to assess its survival prediction accuracy and compare it with the 7th edition.

Study design: Retrospective investigation of prospective data.

Setting: Single-institution tertiary referral center.

Methods: A cohort of 200 patients with hypopharyngeal squamous cell carcinoma who underwent surgical intervention as primary treatment between 2007 and 2019 was analyzed. We evaluated overall survival (OS) and disease-specific survival (DSS) using the Kaplan-Meier method and the log-rank test for each AJCC edition. The Akaike information criterion (AIC) was used to assess prognostic prediction performance.

Results: The median follow-up was 67 months (29-100 months). In total, 93% of the patients (N = 186) underwent at least one side of neck dissection. In total, 41% of patients (N = 82) were upstaged as per the AJCC 8th, all resulting from the redistribution of N stage. Survival curves for DSS were better distinguished for stages I, II, and IVb in the AJCC 8th edition, yet an overlap was observed between stages III and IVa. The combination of extranodal extension (ENE) and cervical metastasis level well-differentiated the survival curves for OS and DSS. The AJCC 8th system outperformed the 7th, with lower AIC values for OS (1092 vs 1098) and DSS (654 vs 666).

Conclusion: The AJCC 8th edition improves survival prediction in hypopharyngeal cancer compared to the 7th, especially with the inclusion of ENE status and nodal metastasis classification revisions.

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第七版与第八版下咽癌手术分期系统之比较。

目的：美国癌症联合委员会（AJCC）第8分期系统对下咽癌的预后准确性仍不确定。我们的目的是评估其生存预测的准确性，并将其与第7版进行比较。研究设计：前瞻性资料的回顾性调查。环境：单一机构三级转诊中心。方法：对2007年至2019年接受手术治疗的200例下咽鳞状细胞癌患者进行队列分析。我们使用Kaplan-Meier方法和log-rank检验评估每个AJCC版本的总生存期（OS）和疾病特异性生存期（DSS）。采用赤池信息准则（Akaike information criterion， AIC）评价预后预测效果。结果：中位随访时间为67个月（29-100个月）。总的来说，93%的患者（N = 186）至少进行了一侧颈部清扫。根据AJCC第8期，总共有41%的患者（N = 82）被抢镜，所有这些都是由于N期的重新分配。在AJCC第8版中，DSS的生存曲线在I、II和IVb期得到了更好的区分，但在III期和IVa期之间观察到重叠。结外延伸（ENE）和宫颈转移水平的结合可以很好地区分OS和DSS的生存曲线。AJCC第8系统的表现优于第7系统，OS （1092 vs 1098）和DSS （654 vs 666）的AIC值较低。结论：与第7版相比，AJCC第8版提高了下咽癌的生存预测，特别是在纳入ENE状态和淋巴结转移分类修订后。

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 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.