Oral tongue carcinoma: prognostic changes according to the updated 2020 version of the AJCC/UICC TNM staging system

Tagliabue, Marta; Berardinis, Rita De; Belloni, Pietro; Gandini, Sara; Scaglione, Donatella; Maffini, Fausto; Mirabella, R.; Riccio, Stefano; Giugliano, Gioacchino; Bruschini, Roberto; Chu, Francesco; Ansarin, Mohssen

doi:10.14639/0392-100x-n2055

Cited by 8 publications

(8 citation statements)

References 17 publications

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“…Considering the significance of IPLN metastasis, a suggestion of the inclusion of IPLN status in LN stage classification was proposed 18 , but this was not realized in the 8th AJCC N classification which was drafted based on head and neck squamous cell carcinoma 19 , prior literature described the official N stage could not well stratify the survival in salivary gland carcinoma 20 , our study also confirmed that the 8th AJCC N stage was not related to DM occurrence. It might be contributed by the distinct difference of biologic behaviour between the two kinds of disease, and the common death cause in parotid cancer was DM but not locoregional recurrence.…”

Section: Discussionsupporting

confidence: 61%

Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma

Han

Wang

et al. 2023

Sci Rep

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To evaluate the relationship between factors of metastatic intraparotid lymph node (IPLN) and distant metastasis in parotid adenoid cystic carcinoma (ACC). Patients with surgically treated parotid ACC were retrospectively enrolled, and primary outcome variable was distant metastasis free survival (DMFS). The effect of factors of metastatic IPLN on DMFS was evaluated using Cox model. In total, 232 patients were included. Extranodal extension of IPLN and cervical lymph nodes did not impact the DMFS, and the 7th but not 8th AJCC N stage was associated with DMFS. Groups of 0 and 1 metastatic IPLN had comparable DMFS, but presence of 2+ positive IPLN was related to increased worse DMFS (p = 0.034, HR 2.09). A new N stage (0 vs 1–2 vs 3+) based on total positive lymph node number exhibited better C-index than traditional N stage. IPLN metastasis increased the risk of distant metastasis, and the impact was mainly determined by the number of metastatic IPLN. Our proposed N stage provided better DMFS prediction than the 8th AJCC N classification.

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Section: Discussionsupporting

confidence: 61%

Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma

Han

Wang

et al. 2023

Sci Rep

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“…17 The 8 th TNM edition of the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging system introduced the tumor depth of invasion (DOI) at the T stage and the incorporation of extracapsular spread (ECS) at the N stage to improve its prognostic value. 18,19 Because the present study was retrospective, data referring to pretreatment imaging examinations and access to histological slides were no longer possible, and we were unable to reclassify the samples using the 8 th TNM edition. Despite this limitation, we believe that the follow-up period of the patients was longer than that in previous studies.…”

Section: Discussionmentioning

confidence: 97%

Clinical outcomes and prognostic factors of head and neck squamous cell carcinoma: a ten-year follow-up study

DIAS,

HILDEBRAND,

CARVALHO

et al. 2023

Braz. oral res.

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Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.

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“…However, the wide difference in oncological outcomes between the early and advanced stages did not change ( 48 – 50 ). Even if the 8 th TNM edition better stratifies the prognosis ( 43 , 51 ), the role of S/G is not considered.…”

Section: Discussionmentioning

confidence: 99%

The prognostic role of sex and hemoglobin levels in patients with oral tongue squamous cell carcinoma

Tagliabue

D’Ecclesiis²,

Berardinis³

et al. 2022

Front. Oncol.

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BackgroundWomen and men differ genetically, biologically (sex) and by social construct (gender), possibly impacting on prognostic factors in predicting cancer survival. Hemoglobin levels and immune system activation are players acting in this scenario which could play a role in partly determining prognosis between patients of different sex/gender (S/G). Here, we investigate these factors in patients affected by tongue squamous cell carcinoma.MethodsThis is an observational retrospective cohort study. We collected tongue cancer patients’ clinical data, including hemoglobin levels and neutrophil lymphocyte ratio (NLR). Overall survival (OS) and disease-free survival (DFS) were compared between women and men considering confounding and prognostic factors in multivariate Cox proportional hazard models. Stratified analyses were also conducted by sex and tumor stage.Result576 patients, 39.9% women and 60.1% men, were found eligible for the analysis. Men were more often smokers (p<0.001), alcohol consumers (p<0.001), overweight or obese (p<0.001) and undergoing radiotherapy (p=0.002). In multivariate models for stage I-II, men showed half risk of death and relapse compared to women (HR=0.44; 95%CI 0.24-0.81, p=0.009; HR=0.55; 95%CI 0.34-0.87, p=0.01, for OS and DFS respectively). Moreover, low hemoglobin levels appeared to be an independent prognostic factor for women but not for men in terms of both OS and DFS. Specifically, women with low hemoglobin levels showed a worse tumor outcome (HR=2.66; 95%CI 1.50-4.70; HR=2.09; 95%CI 1.24-3.53, for OS and DFS respectively). Low hemoglobin levels appeared to be a poor OS prognostic factor for women at stage I-II (p<0.004) but not for men (p=0.10). Women with advanced stage tumors, NLR>2.37, who did not performed Radiotherapy and with depth of invasion (DOI)> 10 were associated with a significant increase in relapse and death (all p<0.05).ConclusionIn our cohort of patients with oral tongue squamous cell carcinoma, men present better OS and DFS than women with early stages tumors. Low hemoglobin level was an independent prognostic factor for women, especially at early-stage tumors. For advanced stages (III-IV), sex is not a significant factor related to patients’ prognosis.

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Oral tongue carcinoma: prognostic changes according to the updated 2020 version of the AJCC/UICC TNM staging system

Cited by 8 publications

References 17 publications

Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma

Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma

Clinical outcomes and prognostic factors of head and neck squamous cell carcinoma: a ten-year follow-up study

The prognostic role of sex and hemoglobin levels in patients with oral tongue squamous cell carcinoma

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