7th vs 8th edition of AJCC staging system: any improvement for patients with squamous cell carcinoma of the tongue?

Publication date: Available online 18 August 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Marco Mascitti, Corrado Rubini, Francesco De Michele, Paolo Balercia, Riccardo Girotto, Giuseppe Troiano, Lorenzo Lo Muzio, Andrea Santarelli

ABSTRACT

Objective. In this study we evaluate the 8th edition of American Joint Committee on Cancer (AJCC) staging criteria and lymph node ratio (LNR) to identify patients affected by squamous cell carcinoma of the tongue (SCCT) with worse prognosis.

Study Design. 73 patients with SCCT were analyzed retrospectively. Tumors staging was revised according to 7th and 8th editions of AJCC. Depth of invasion (DOI), extranodal extension (ENE), and LNR were evaluated.

Results. 25 patients were reclassified: 17 received an upstage in staging score, 8 changed pT or pN remaining in the same stage group. In pT upstaged group, 7 patients experienced recurrence and 8 died. In pN upstaged group, 9 patients developed recurrence and 10 died. The number of disease recurrence or death was higher in the groups who received an upstage in pN and in staging score (P<0.05). pN upstaged group showed worse disease-free survival (DFS) and overall survival (OS) (P<0.05). LNR was higher in patients with recurrence, and among these LNR was lower in patients with ENE (P<0.05).

Conclusions. The 8th edition of AJCC allows a better stratification of SCCT patients. The implementation of ENE and LNR to pN classification seems to identify patients with worse DFS and OS.

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