Preoperative Staging in Oral Cavity Cancer: Nationwide Practice and Concordance With Pathology.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral diseases Pub Date : 2025-08-31 DOI:10.1111/odi.70082

Hanneke Doremiek van Oorschot, Julie Maria Leonardus Sijmons, Jose Angelito Hardillo, Robert Jan Baatenburg de Jong

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引用次数: 0

Abstract

Objectives: The clarity of TNM-classification for oral cancer has a direct impact on healthcare resource allocation, treatment decisions, morbidity, and clinical outcomes. However, possible TNM ambiguity between hospitals exists due to the broad range of available diagnostics. Therefore, this study aims to assess current practice variation in preoperative staging for oral cavity cancer.

Materials and methods: All patients who underwent primary oral cavity cancer resection in the Netherlands between 2018 and 2021 were selected from the Dutch Head and Neck Audit database. Preoperative staging (cTN) was compared to definitive pathology staging (pTN) as the gold standard for assessing concordance at national and hospital levels.

Results: Disease stage was upstaged in 27.5% of the patients. For T-classification analysis, 2458 patients were included. Accuracy for T-classification categories was 85.2%-93.1%, but significant hospital variation in overstaging and understaging was observed. For N-classification analysis, 1746 patients were included. Preoperative assessment of node involvement missed metastasis in 25.1% of the cN0 patients, resulting in 77.3% accuracy.

Conclusion: Significant preoperative understaging of oral cancer calls the attention to the difficulties of the diagnostics of oral cancer. Although the accuracy of preoperative staging in oral cavity cancer is high, significant differences between hospitals were observed.

查看原文本刊更多论文

口腔癌的术前分期：全国实践与病理一致。

目的：口腔癌tnm分类的清晰度对医疗资源分配、治疗决策、发病率和临床结果有直接影响。然而，由于可用的诊断方法范围广泛，医院之间可能存在TNM歧义。因此，本研究旨在评估目前口腔癌术前分期的实践差异。材料和方法：从荷兰头颈审计数据库中选择2018年至2021年期间在荷兰接受原发性口腔癌切除术的所有患者。术前分期（cTN）与最终病理分期（pTN）进行比较，作为评估国家和医院水平一致性的金标准。结果：27.5%的患者疾病分期提前。t分类分析纳入2458例患者。t型分类的准确率为85.2%-93.1%，但不同医院在分期过分期和分期不足方面存在显著差异。n分类分析纳入1746例患者。25.1%的cN0患者术前评估未发现淋巴结转移，准确率为77.3%。结论：口腔癌术前明显的欠分期引起了人们对口腔癌诊断难点的重视。虽然口腔癌术前分期的准确性很高，但不同医院间存在显著差异。

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

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.