Comparison of the 8th edition of TNM staging of oral cancer with the 7th edition and its prognostic significance using clinical depth of invasion and extranodal extension

Yokota, Yusuke; Hasegawa, Takumi; Yamakawa, Nobuhiro; Rin, Shin; Otsuru, Mitsunobu; Yamada, Shin‐ichi; Hirai, Eiji; Ashikaga, Yuichi; Yamamoto, Kozo; Kirita, Tadaaki; Umeda, Masahiro; Akashi, Mitsuru; Kitamura, Hiroshi; Ohiro, Yoichi; Yanamoto, Souichi; Okura, Masaya

doi:10.1016/j.oraloncology.2023.106519

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…Secondly, the TNM staging adopted in this study was based on the 7th but not the currently applied 8th AJCC classification system. Considering that a study involving more than 2000 patients found the upgraded classification was more likely to change stage at T3‐4 and N2, 44 our adoption of the 7th AJCC edition classification for TSCC patients of T1‐2N0‐1 stage, particularly when 77.5% (341 out of 440) of the patients were in early stage (pT1‐2N0M0), may bear less divergence owing to the choice of the classification edition. Furthermore, the low proportion of cases who received postoperative adjuvant therapy limits the strength of conclusions in this context.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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PurposeThe study aimed to retrospectively identify the prognostic factors of surgically treated primary tongue squamous cell carcinoma (TSCC) cases and assess the benefits of surgical neck lymph node dissection (LND) in early‐stage cancer.MethodsPatients with primary TSCC with pT1‐2N0‐1M0 stage without distant metastasis who were treated with surgery during 2014–2016 at Xiangya Hospital, Central South University were included. Univariate and multivariate Cox models were constructed to explore prognostic factors of overall survival (OS), disease‐free survival (DFS), and local recurrence‐free survival (LRFS). Sub‐group analysis was used to assess the effect of adjuvant therapy and the prognostic value of LND for the early‐stage patients.ResultsIn total, 440 patients met the inclusion criteria. During the follow‐up period, the 5‐year OS, DFS, were 84.4% and 70.0%, respectively. Univariate analysis showed that TNM stage, lymphovascular invasion (LVI), and/or perineural invasion (PNI), pathological differentiation, etc. were significant predictors of OS and DFS. Multivariate analysis showed that TNM stage and the degree of pathological differentiation were independent prognostic factors for all outcomes. Besides, the number of cervical LND could independently predict both DFS and LRFS while LVI/PNI were associated with DFS. And high‐quality neck LND (≥30) significantly improved DFS and LRFS for patients of pT1cN0M0 or stage I as compared to those without LND.ConclusionsTNM stage and pathological differentiation were crucial prognostic factors for postoperative patients with TSCC. Notably, high‐quality cervical LND was beneficial for the improvement of DFS and LRFS for patients of pT1cN0M0 or stage I.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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“…This adjustment did not alter the survival predictions. Disease extent, as measured by the TNM stage, presently predicted HNSCC survival [54]. Smoking causes HNSCC and is also an inflammatory driver [55].…”

Section: Discussionmentioning

confidence: 99%

Plasma IL-1 and IL-6 Family Cytokines with Soluble Receptor Levels at Diagnosis in Head and Neck Squamous Cell Carcinoma: High Levels Predict Decreased Five-Year Disease-Specific and Overall Survival

Aarstad,

Moe,

Lybak

et al. 2024

Cancers

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Activation of the acute-phase cascade (APC) has been correlated with outcomes in various cancers, including head and neck squamous cell carcinoma (HNSCC). Primary drivers of the APC are the cytokines within the interleukin-6 (IL-6) and IL-1 families. Plasma levels of IL-6 family cytokines/soluble receptors (IL-6, IL-27, IL-31, OSM, CNTF, soluble (s-)gp130, s-IL-6Rα) and IL-1 family members (IL-1RA, s-IL-33Rα) were determined at diagnosis for 87 human papillomavirus (HPV)-negative (−) HNSCC patients. We then studied the 5-year Disease-Specific Survival (DSS) and Overall Survival (OS). Increased plasma levels of IL-6 (p < 0.001/p < 0.001) (DSS/OS), IL-31 (p = 0.044/p = 0.07), IL-1RA (p = 0.004/p = 0.035), soluble (s)-IL-6Rα p = 0.022/p = 0.035), and s-gp130 (p = 0.007/p = 0.003) at diagnosis were predictors of both OS and DSS from HPV(−) HNSCC patients. The cytokine DSS/OS predictions were associated with TNM stage and smoking history, whereas the soluble receptors IL-6Rα, gp130, and IL33Rα more uniquely predicted DSS/OS. Clinically, IL-6 levels above 2.5 pg/mL yielded 75% specificity and 70% sensitivity for DSS. In conclusion, high plasma levels of IL-6, IL-31, and IL-1RA, as well as the soluble receptors IL-6Rα, gp130, and IL33Rα, predicted clinical outcome. This shows their potential as candidates for both general therapy and immune therapy stratification, as well as being future platforms for the development of new immunotherapy.

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“…As deeper DOI is a predictor of poorer relapse-free and overall survival, it has also been hypothesized to subdivide stage III OSCC based on DOI cut-off [36]. Undoubtedly, the eighth edition of the TNM clinical staging system has improved the ability to discriminate and prognosticate OSCC, by identifying patients with higher mortality rated through the application of clinical DOI and extranodal extension [2].…”

Section: Discussionmentioning

confidence: 99%

“…The parameter of depth of invasion (DOI), defined as the distance between the normal mucosal surface and the deepest margin of a neoplastic lesion in the tissues, has been proven to be a valid prognosticator of oral squamous cell carcinoma, and is recognized as a T-stage modifier by the eighth edition of the American Joint Committee on Cancer (AJCC) criteria [1,2]. The assessment of DOI can be predictive of cervical lymph nodes involvement, as well as facilitating the achievement of clear surgical margins, allowing an improved local disease control and preventing recurrence [3].…”

Section: Introductionmentioning

confidence: 99%

The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis

Nisi,

Gennai,

Graziani

et al. 2023

Diagnostics

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Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of the present study is to review the evidence on the application of intraoral ultrasonography to the assessment of DOI in patients affected by OSCC. A systematic electronic and manual literature search was performed, and data from eligible studies were reviewed, selected, and extracted. The studies had to report the correlation between DOI estimated with ultrasonography versus histopathology. A meta-analysis was conducted on the quantitative data available. Sixteen articles were included in the review following the screening of the initial 228 studies retrieved from the literature. The meta-analysis showed a significant correlation between ultrasonographic and histopathologic measurements (p < 0.01). The studies were all at low/moderate risk of bias. Ultrasonography appears a valuable tool for DOI assessment.

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Comparison of the 8th edition of TNM staging of oral cancer with the 7th edition and its prognostic significance using clinical depth of invasion and extranodal extension

Cited by 6 publications

References 25 publications

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Plasma IL-1 and IL-6 Family Cytokines with Soluble Receptor Levels at Diagnosis in Head and Neck Squamous Cell Carcinoma: High Levels Predict Decreased Five-Year Disease-Specific and Overall Survival

The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis

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