Oral SCC: study identifies most accurate nodal staging systems

  • Oral Oncol

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • In a comparative analysis, positive lymph node number (PN) and lymph node ratio (LNR) best predicted OS and disease-free survival (DFS) in patients with oral squamous cell carcinoma (OSCC).

Why this matters

  • The current American Joint Committee on Cancer (AJCC) staging system showed poor discrimination between substages of pN2.

Key results

  • PN and LNR had better discrimination than AJCC eighth edition for 5-year DFS prediction:
    • PN: 74%, 52%, 27%, and 18% for 0, 1-2, 3-4, and ≥5, respectively; Harrell’s C-index 0.7156.
    • LNR: 74%, 54%, 37%, and 15% for 0, 0.4, respectively; Harrell’s C-index 0.7145.
    • AJCC: 74%, 53%, 50%, 47%, 24%, and 0% for pN0, pN1, pN2a, pN2b, pN2c, and pN3b, respectively; Harrell’s C-index 0.7103.
  • PN and LNR had better discrimination than AJCC eighth edition for 5-year OS:
    • PN: 85%, 70%, 27%, and 18% for 0, 1-2, 3-4, and ≥5, respectively; Harrell’s C-index 0.7600.
    • LNR: 85%, 73%, 52%, and 14% for 0, 0.4, respectively; Harrell’s C-index 0.7552.
    • AJCC: 85%, 73%, 50%, 53%, 20%, and 0% for pN0, pN1, pN2a, pN2b, pN2c, and pN3b, respectively; Harrell’s C-index 0.7503.

Study design

  • Data for 643 patients with OSCC treated with surgery ± adjuvant therapy.
  • Funding: None disclosed.

Limitations

  • Retrospective study.

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