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Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma
AIMS: In the 8th edition of the American Joint Committee on Cancer TNM staging manual, tumour infiltration depth and extranodal extension are added to the pathological classification for oral squamous cell carcinoma. The currently available 8th TNM validation studies lack patients with conservative...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851684/ https://www.ncbi.nlm.nih.gov/pubmed/31021008 http://dx.doi.org/10.1111/his.13886 |
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author | Boeve, Koos Melchers, Lieuwe J Schuuring, Ed Roodenburg, Jan L Halmos, Gyorgy B van Dijk, Boukje A van der Vegt, Bert Witjes, Max J |
author_facet | Boeve, Koos Melchers, Lieuwe J Schuuring, Ed Roodenburg, Jan L Halmos, Gyorgy B van Dijk, Boukje A van der Vegt, Bert Witjes, Max J |
author_sort | Boeve, Koos |
collection | PubMed |
description | AIMS: In the 8th edition of the American Joint Committee on Cancer TNM staging manual, tumour infiltration depth and extranodal extension are added to the pathological classification for oral squamous cell carcinoma. The currently available 8th TNM validation studies lack patients with conservative neck treatment, and changes in the classification especially affect patients with small tumours. The aim of this study was to determine the potential impact of the changes in the 8th edition pTNM classification on the prognosis and treatment strategy for oral squamous cell carcinoma in a well‐defined series of pT1–T2 patients with long‐term follow‐up. METHODS AND RESULTS: Two hundred and eleven first primary pT1–T2 oral squamous cell carcinoma patients, with surgical resection as primary treatment, were analysed retrospectively. One hundred and seventy‐three patients underwent a neck dissection, and 38 patients had frequent clinical neck assessments. Long‐term follow‐up (median 64 months) and reassessed tumour infiltration depth were available. Classification according to the 8th edition criteria resulted in 36% total upstaging with the T classification and 16% total upstaging with the N classification. T3‐restaged patients (n = 30, 14%) had lower 5‐year disease‐specific survival rates than T2‐staged patients (81% versus 67%, P = 0.042). Postoperative (chemo)radiotherapy could have been considered in another seven (3%) patients on the basis of the 8th edition criteria. CONCLUSIONS: Addition of tumour infiltration depth and extranodal extension in the 8th TNM classification leads to the identification of oral squamous cell carcinoma patients with a worse prognosis who might benefit from an improved postoperative treatment strategy. |
format | Online Article Text |
id | pubmed-6851684 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-68516842019-11-18 Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma Boeve, Koos Melchers, Lieuwe J Schuuring, Ed Roodenburg, Jan L Halmos, Gyorgy B van Dijk, Boukje A van der Vegt, Bert Witjes, Max J Histopathology Original Articles AIMS: In the 8th edition of the American Joint Committee on Cancer TNM staging manual, tumour infiltration depth and extranodal extension are added to the pathological classification for oral squamous cell carcinoma. The currently available 8th TNM validation studies lack patients with conservative neck treatment, and changes in the classification especially affect patients with small tumours. The aim of this study was to determine the potential impact of the changes in the 8th edition pTNM classification on the prognosis and treatment strategy for oral squamous cell carcinoma in a well‐defined series of pT1–T2 patients with long‐term follow‐up. METHODS AND RESULTS: Two hundred and eleven first primary pT1–T2 oral squamous cell carcinoma patients, with surgical resection as primary treatment, were analysed retrospectively. One hundred and seventy‐three patients underwent a neck dissection, and 38 patients had frequent clinical neck assessments. Long‐term follow‐up (median 64 months) and reassessed tumour infiltration depth were available. Classification according to the 8th edition criteria resulted in 36% total upstaging with the T classification and 16% total upstaging with the N classification. T3‐restaged patients (n = 30, 14%) had lower 5‐year disease‐specific survival rates than T2‐staged patients (81% versus 67%, P = 0.042). Postoperative (chemo)radiotherapy could have been considered in another seven (3%) patients on the basis of the 8th edition criteria. CONCLUSIONS: Addition of tumour infiltration depth and extranodal extension in the 8th TNM classification leads to the identification of oral squamous cell carcinoma patients with a worse prognosis who might benefit from an improved postoperative treatment strategy. John Wiley and Sons Inc. 2019-07-29 2019-09 /pmc/articles/PMC6851684/ /pubmed/31021008 http://dx.doi.org/10.1111/his.13886 Text en © 2019 The Authors. Histopathology Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Boeve, Koos Melchers, Lieuwe J Schuuring, Ed Roodenburg, Jan L Halmos, Gyorgy B van Dijk, Boukje A van der Vegt, Bert Witjes, Max J Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title | Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title_full | Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title_fullStr | Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title_full_unstemmed | Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title_short | Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early‐stage oral squamous cell carcinoma |
title_sort | addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological tnm classification for early‐stage oral squamous cell carcinoma |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851684/ https://www.ncbi.nlm.nih.gov/pubmed/31021008 http://dx.doi.org/10.1111/his.13886 |
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