Narayana Subramaniam , Gillian Heller , Jonathan Robert Clark , Ruta Gupta , David Goldstein , John R. de Almeida , Ali Hosni , Deepak Balasubramanian , Krishnakumar Thankappan , Subramania Iyer , Martin Batstone , N. Gopal Iyer , Robert I. Smee , Naveen Hedne Chandrasekhar , Vijay Pillai , Vivek Shetty , Vidyabhushan Rangappa , Michael Veness , Tsu-Hui (Hubert) Low
{"title":"提高口腔癌结节分期的准确性:新系统提案","authors":"Narayana Subramaniam , Gillian Heller , Jonathan Robert Clark , Ruta Gupta , David Goldstein , John R. de Almeida , Ali Hosni , Deepak Balasubramanian , Krishnakumar Thankappan , Subramania Iyer , Martin Batstone , N. Gopal Iyer , Robert I. Smee , Naveen Hedne Chandrasekhar , Vijay Pillai , Vivek Shetty , Vidyabhushan Rangappa , Michael Veness , Tsu-Hui (Hubert) Low","doi":"10.1016/j.suronc.2024.102033","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Despite introduction of extranodal extension (ENE) into the AJCC 8th edition of oral cancer staging, previous criticisms persist, such as limited discrimination between sub-stages and doubtful prognostic value of contralateral<span> nodal disease. The purpose of this study was to compare our novel nodal staging system, based on the number of positive nodes and ENE, to the AJCC staging system in surgically treated patients.</span></p></div><div><h3>Methods</h3><p>Retrospective analysis of 4710 patients with oral squamous cell carcinoma<span> (OSCC) treated with surgery±adjuvant therapy in 8 institutions in Australia, North America and Asia. With overall survival (OS) and disease specific survival (DSS) as endpoint, the prognostic performance of AJCC 8th and 7th editions were compared using hazard consistency, hazard discrimination, likelihood difference and balance.</span></p></div><div><h3>Results</h3><p>Our new nodal staging system (PN) a progressive and linear increase in hazard ratio (HR) from pN0 to pN3, with good separation of Kaplan Meier curves. Using the predetermined criteria for evaluation of a staging system, our proposed staging model outperformed AJCC 8th and 7th editions in prediction of OS and DSS.</p></div><div><h3>Conclusion</h3><p>PN was the lymph node staging system that provided the most accurate prediction of OS and DSS for patients in our cohort of OSCC. Additionally, it can be easily adopted, addresses the shortcomings of the existing systems and should be considered for future editions of the TNM staging system.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improving accuracy in nodal staging of oral cancer: Proposal of a new system\",\"authors\":\"Narayana Subramaniam , Gillian Heller , Jonathan Robert Clark , Ruta Gupta , David Goldstein , John R. de Almeida , Ali Hosni , Deepak Balasubramanian , Krishnakumar Thankappan , Subramania Iyer , Martin Batstone , N. Gopal Iyer , Robert I. Smee , Naveen Hedne Chandrasekhar , Vijay Pillai , Vivek Shetty , Vidyabhushan Rangappa , Michael Veness , Tsu-Hui (Hubert) Low\",\"doi\":\"10.1016/j.suronc.2024.102033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Despite introduction of extranodal extension (ENE) into the AJCC 8th edition of oral cancer staging, previous criticisms persist, such as limited discrimination between sub-stages and doubtful prognostic value of contralateral<span> nodal disease. The purpose of this study was to compare our novel nodal staging system, based on the number of positive nodes and ENE, to the AJCC staging system in surgically treated patients.</span></p></div><div><h3>Methods</h3><p>Retrospective analysis of 4710 patients with oral squamous cell carcinoma<span> (OSCC) treated with surgery±adjuvant therapy in 8 institutions in Australia, North America and Asia. With overall survival (OS) and disease specific survival (DSS) as endpoint, the prognostic performance of AJCC 8th and 7th editions were compared using hazard consistency, hazard discrimination, likelihood difference and balance.</span></p></div><div><h3>Results</h3><p>Our new nodal staging system (PN) a progressive and linear increase in hazard ratio (HR) from pN0 to pN3, with good separation of Kaplan Meier curves. Using the predetermined criteria for evaluation of a staging system, our proposed staging model outperformed AJCC 8th and 7th editions in prediction of OS and DSS.</p></div><div><h3>Conclusion</h3><p>PN was the lymph node staging system that provided the most accurate prediction of OS and DSS for patients in our cohort of OSCC. Additionally, it can be easily adopted, addresses the shortcomings of the existing systems and should be considered for future editions of the TNM staging system.</p></div>\",\"PeriodicalId\":51185,\"journal\":{\"name\":\"Surgical Oncology-Oxford\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-01-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgical Oncology-Oxford\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S096074042400001X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Oncology-Oxford","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S096074042400001X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Improving accuracy in nodal staging of oral cancer: Proposal of a new system
Background
Despite introduction of extranodal extension (ENE) into the AJCC 8th edition of oral cancer staging, previous criticisms persist, such as limited discrimination between sub-stages and doubtful prognostic value of contralateral nodal disease. The purpose of this study was to compare our novel nodal staging system, based on the number of positive nodes and ENE, to the AJCC staging system in surgically treated patients.
Methods
Retrospective analysis of 4710 patients with oral squamous cell carcinoma (OSCC) treated with surgery±adjuvant therapy in 8 institutions in Australia, North America and Asia. With overall survival (OS) and disease specific survival (DSS) as endpoint, the prognostic performance of AJCC 8th and 7th editions were compared using hazard consistency, hazard discrimination, likelihood difference and balance.
Results
Our new nodal staging system (PN) a progressive and linear increase in hazard ratio (HR) from pN0 to pN3, with good separation of Kaplan Meier curves. Using the predetermined criteria for evaluation of a staging system, our proposed staging model outperformed AJCC 8th and 7th editions in prediction of OS and DSS.
Conclusion
PN was the lymph node staging system that provided the most accurate prediction of OS and DSS for patients in our cohort of OSCC. Additionally, it can be easily adopted, addresses the shortcomings of the existing systems and should be considered for future editions of the TNM staging system.
期刊介绍:
Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.