PMID- 31090934
OWN - NLM
STAT- MEDLINE
DCOM- 20200512
LR  - 20200512
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 125
IP  - 17
DP  - 2019 Sep 1
TI  - Pathologic staging changes in oral cavity squamous cell carcinoma: Stage 
      migration and implications for adjuvant treatment.
PG  - 2975-2983
LID - 10.1002/cncr.32161 [doi]
AB  - BACKGROUND: The eighth edition of the AJCC Cancer Staging Manual (AJCC 8) 
      incorporates depth of invasion (DOI) into the pathologic tumor (pT) 
      classification and pathologic extranodal extension (pENE) into the pathologic 
      nodal (pN) classification for oral cavity squamous cell carcinoma (OCSCC). This 
      study evaluated the incidence and prognostic importance of stage migration as a 
      result of these changes in the AJCC 8 staging system. METHODS: From the National 
      Cancer Database, cohorts were identified from patients with OCSCC undergoing 
      definitive surgery between 2004 and 2013 for pT (n = 7184), pN (n = 13,627), and 
      pathologic stage (pStage) analysis (n = 5580). RESULTS: DOI and pENE were 
      prognostic in all groups except for pN3 according to the seventh edition of the 
      AJCC Cancer Staging Manual (AJCC 7). Upstaging was seen in 12.4% of patients for 
      the pT classification, in 13.3% for the pN classification, and in 24.8% for the 
      overall pStage grouping. Notably, upstaging led to similar or improved 5-year 
      overall survival (OS) for every AJCC 8 pT/N classification except pStage IVB. 
      Patients with AJCC 7 pT1 tumors that were upstaged to AJCC 8 pT3 tumors had 
      improved OS in comparison with the remainder of the pT3 group (71.7% vs 43.7%; 
      P < .0001). A multivariable analysis of upstaged pT3N0 patients demonstrated a 
      reduced risk of death with the receipt of postoperative radiotherapy (PORT; 
      hazard ratio, 0.56; 95% confidence interval, 0.33-0.95; P = .03). CONCLUSIONS: 
      Upstaging is common in AJCC 8, and patients with upstaged tumors demonstrate 
      improved survival; these factors should be kept in mind when one is interpreting 
      data with the new staging system. PORT may reduce deaths among newly upstaged 
      pT3N0 patients, and further study is needed in this area.
CI  - (c) 2019 American Cancer Society.
FAU - Lee, Nicholas C J
AU  - Lee NCJ
AD  - Department of Therapeutic Radiology, Yale School of Medicine, New Haven, 
      Connecticut.
FAU - Eskander, Antoine
AU  - Eskander A
AD  - Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, 
      Canada.
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Park, Henry S
AU  - Park HS
AD  - Department of Therapeutic Radiology, Yale School of Medicine, New Haven, 
      Connecticut.
FAU - Mehra, Saral
AU  - Mehra S
AD  - Section of Otolaryngology, Department of Surgery, Yale School of Medicine, New 
      Haven, Connecticut.
FAU - Burtness, Barbara A
AU  - Burtness BA
AD  - Section of Medical Oncology, Department of Internal Medicine, Yale School of 
      Medicine, New Haven, Connecticut.
AD  - Yale Cancer Center, New Haven, Connecticut.
FAU - Husain, Zain
AU  - Husain Z
AD  - Department of Therapeutic Radiology, Yale School of Medicine, New Haven, 
      Connecticut.
AD  - Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, 
      Canada.
AD  - Department of Radiation Oncology, University of Toronto, Toronto, Ontario, 
      Canada.
LA  - eng
GR  - T35 DK104689/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190515
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - IM
MH  - Aged
MH  - Carcinoma, Squamous Cell/*mortality/*pathology
MH  - Cell Movement
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mouth Neoplasms/*mortality/*pathology
MH  - Multivariate Analysis
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Survival Analysis
OTO - NOTNLM
OT  - American Joint Committee on Cancer (AJCC)
OT  - TNM staging
OT  - Will Rogers phenomenon
OT  - head and neck cancer
OT  - oral cavity
OT  - prognosis
OT  - radiation therapy
OT  - volume
EDAT- 2019/05/16 06:00
MHDA- 2020/05/13 06:00
CRDT- 2019/05/16 06:00
PHST- 2019/03/01 00:00 [received]
PHST- 2019/03/25 00:00 [revised]
PHST- 2019/03/31 00:00 [accepted]
PHST- 2019/05/16 06:00 [pubmed]
PHST- 2020/05/13 06:00 [medline]
PHST- 2019/05/16 06:00 [entrez]
AID - 10.1002/cncr.32161 [doi]
PST - ppublish
SO  - Cancer. 2019 Sep 1;125(17):2975-2983. doi: 10.1002/cncr.32161. Epub 2019 May 15.