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Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck

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Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck. / Moeckelmann, Nikolaus; Ebrahimi, Ardalan; Dirven, Richard; Liu, Jessica; Low, Tsu-Hui Hubert; Gupta, Ruta; Ashford, Bruce; Ch'ng, Sydney; Palme, Carsten E; Clark, Jonathan R.

in: ANN SURG ONCOL, Jahrgang 25, Nr. 6, 06.2018, S. 1730-1736.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Moeckelmann, N, Ebrahimi, A, Dirven, R, Liu, J, Low, T-HH, Gupta, R, Ashford, B, Ch'ng, S, Palme, CE & Clark, JR 2018, 'Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck', ANN SURG ONCOL, Jg. 25, Nr. 6, S. 1730-1736. https://doi.org/10.1245/s10434-018-6340-x

APA

Moeckelmann, N., Ebrahimi, A., Dirven, R., Liu, J., Low, T-H. H., Gupta, R., Ashford, B., Ch'ng, S., Palme, C. E., & Clark, J. R. (2018). Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck. ANN SURG ONCOL, 25(6), 1730-1736. https://doi.org/10.1245/s10434-018-6340-x

Vancouver

Moeckelmann N, Ebrahimi A, Dirven R, Liu J, Low T-HH, Gupta R et al. Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck. ANN SURG ONCOL. 2018 Jun;25(6):1730-1736. https://doi.org/10.1245/s10434-018-6340-x

Bibtex

@article{2d1a5df9d0fd4093a4304e274c4d0583,
title = "Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck",
abstract = "BACKGROUND: The American Joint Committee on Cancer (AJCC) uses the same nodal staging system for cutaneous and mucosal squamous cell carcinoma of the head and neck in its 8th edition (AJCC 8) despite differences in the etiology, risk factors, and clinical behavior of the two diseases. This study aims to evaluate the performance of the AJCC 8 nodal staging system by direct comparison of cutaneous (cSCC) versus oral squamous cell carcinoma (oSCC) patients.METHODS: Patients with metastatic cSCC (N = 382) and oSCC (N = 325) were identified from a prospective database (years 1987-2016). Multivariable analysis was performed using Cox proportional hazards competing risk model. To assess staging system performance, an explained variation measure (proportion of variation explained, PVE) as well as a discrimination measure (Harrell's concordance index, C-index) were used.RESULTS: Inclusion of extranodal extension (ENE) in AJCC 8 increased the proportion of patients in N3b category (48.7% in cSCC, 40.3% in oSCC). AJCC 8 stratified poorly with regards to risk of death from cSCC and oSCC and showed limited monotonicity of the nodal categories. Estimates of model performance revealed modest predictive capacity for overall survival (OS) and disease-specific survival (DSS) in oSCC (Harrell's C of 0.66 in both) and weak predictive capacity in cSCC (Harrell's C of 0.58 and 0.61, respectively).CONCLUSIONS: The AJCC 8 nodal staging system performs poorly in terms of stratifying survival by N category, especially in cSCC. The data indicate that cSCC merits an independent nodal staging system from that for mucosal SCC.",
keywords = "Journal Article",
author = "Nikolaus Moeckelmann and Ardalan Ebrahimi and Richard Dirven and Jessica Liu and Low, {Tsu-Hui Hubert} and Ruta Gupta and Bruce Ashford and Sydney Ch'ng and Palme, {Carsten E} and Clark, {Jonathan R}",
year = "2018",
month = jun,
doi = "10.1245/s10434-018-6340-x",
language = "English",
volume = "25",
pages = "1730--1736",
journal = "ANN SURG ONCOL",
issn = "1068-9265",
publisher = "Springer New York",
number = "6",

}

RIS

TY - JOUR

T1 - Analysis and Comparison of the 8th Edition American Joint Committee on Cancer (AJCC) Nodal Staging System in Cutaneous and Oral Squamous Cell Cancer of the Head and Neck

AU - Moeckelmann, Nikolaus

AU - Ebrahimi, Ardalan

AU - Dirven, Richard

AU - Liu, Jessica

AU - Low, Tsu-Hui Hubert

AU - Gupta, Ruta

AU - Ashford, Bruce

AU - Ch'ng, Sydney

AU - Palme, Carsten E

AU - Clark, Jonathan R

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: The American Joint Committee on Cancer (AJCC) uses the same nodal staging system for cutaneous and mucosal squamous cell carcinoma of the head and neck in its 8th edition (AJCC 8) despite differences in the etiology, risk factors, and clinical behavior of the two diseases. This study aims to evaluate the performance of the AJCC 8 nodal staging system by direct comparison of cutaneous (cSCC) versus oral squamous cell carcinoma (oSCC) patients.METHODS: Patients with metastatic cSCC (N = 382) and oSCC (N = 325) were identified from a prospective database (years 1987-2016). Multivariable analysis was performed using Cox proportional hazards competing risk model. To assess staging system performance, an explained variation measure (proportion of variation explained, PVE) as well as a discrimination measure (Harrell's concordance index, C-index) were used.RESULTS: Inclusion of extranodal extension (ENE) in AJCC 8 increased the proportion of patients in N3b category (48.7% in cSCC, 40.3% in oSCC). AJCC 8 stratified poorly with regards to risk of death from cSCC and oSCC and showed limited monotonicity of the nodal categories. Estimates of model performance revealed modest predictive capacity for overall survival (OS) and disease-specific survival (DSS) in oSCC (Harrell's C of 0.66 in both) and weak predictive capacity in cSCC (Harrell's C of 0.58 and 0.61, respectively).CONCLUSIONS: The AJCC 8 nodal staging system performs poorly in terms of stratifying survival by N category, especially in cSCC. The data indicate that cSCC merits an independent nodal staging system from that for mucosal SCC.

AB - BACKGROUND: The American Joint Committee on Cancer (AJCC) uses the same nodal staging system for cutaneous and mucosal squamous cell carcinoma of the head and neck in its 8th edition (AJCC 8) despite differences in the etiology, risk factors, and clinical behavior of the two diseases. This study aims to evaluate the performance of the AJCC 8 nodal staging system by direct comparison of cutaneous (cSCC) versus oral squamous cell carcinoma (oSCC) patients.METHODS: Patients with metastatic cSCC (N = 382) and oSCC (N = 325) were identified from a prospective database (years 1987-2016). Multivariable analysis was performed using Cox proportional hazards competing risk model. To assess staging system performance, an explained variation measure (proportion of variation explained, PVE) as well as a discrimination measure (Harrell's concordance index, C-index) were used.RESULTS: Inclusion of extranodal extension (ENE) in AJCC 8 increased the proportion of patients in N3b category (48.7% in cSCC, 40.3% in oSCC). AJCC 8 stratified poorly with regards to risk of death from cSCC and oSCC and showed limited monotonicity of the nodal categories. Estimates of model performance revealed modest predictive capacity for overall survival (OS) and disease-specific survival (DSS) in oSCC (Harrell's C of 0.66 in both) and weak predictive capacity in cSCC (Harrell's C of 0.58 and 0.61, respectively).CONCLUSIONS: The AJCC 8 nodal staging system performs poorly in terms of stratifying survival by N category, especially in cSCC. The data indicate that cSCC merits an independent nodal staging system from that for mucosal SCC.

KW - Journal Article

U2 - 10.1245/s10434-018-6340-x

DO - 10.1245/s10434-018-6340-x

M3 - SCORING: Journal article

C2 - 29352431

VL - 25

SP - 1730

EP - 1736

JO - ANN SURG ONCOL

JF - ANN SURG ONCOL

SN - 1068-9265

IS - 6

ER -