Department for Oral and Maxillofacial Plastic Surgery, University of Cologne, Germany; Center of Integrated Oncology (CIO), Cologne-Bonn, Germany.
Department for Oral and Maxillofacial Plastic Surgery, University of Cologne, Germany; Center of Integrated Oncology (CIO), Cologne-Bonn, Germany.
Oral Oncol. 2013 Sep;49(9):903-910. doi: 10.1016/j.oraloncology.2013.06.009. Epub 2013 Jul 10.
Although the UICC/AJCC's TNM staging of the 7th edition was improved in 2002, there are still shortcomings concerning the prognostic quality. Alternative TNM-based stage-groupings such as the T and N Integer Score (TANIS) where shown to have a better prognostic quality for various kinds of head and neck tumors in the past. The aim of the study was to compare the prognostic value of the 7th edition of the UICC/AJCC TNM-classification for carcinoma of the parotid gland with different TNM-based stage groupings.
The retrospective analysis included 180 patients with carcinoma of the parotid gland diagnosed between 1986 and 2007. The stage grouping system of the 7th edition of the UICC/AJCC and TNM-based stage-groupings (TANIS-3, TANIS-8, Snyderman, Berg and Hart) were tested for their prognostic significance. Overall survival (OS) was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis.
In univariate analysis all stage-groupings had a highly significant impact on overall survival (p<0.05), however in multivariate analysis, only the TANIS-8 scheme (p=0.008) and Snyderman scheme (p=0.047) predicted OS, while the UICC/AJCC-classification did not predict OS significantly (p=0.381).
In comparison to other TNM-based stage groupings the UICC/AJCC-classification did not provide significant prediction of OS, while alternative stage-groupings such as the TANIS-8 had a higher prognostic value.
尽管 UICC/AJCC 的第 7 版 TNM 分期在 2002 年得到了改进，但在预后质量方面仍存在不足。过去的研究表明，替代基于 TNM 的分期系统，如 T 和 N 整数评分（TANIS），对于各种头颈部肿瘤具有更好的预后质量。本研究旨在比较第 7 版 UICC/AJCC TNM 分类与不同基于 TNM 的分期系统对腮腺癌的预后价值。
回顾性分析了 1986 年至 2007 年间诊断为腮腺癌的 180 例患者。测试了第 7 版 UICC/AJCC 分期系统和基于 TNM 的分期系统（TANIS-3、TANIS-8、Snyderman、Berg 和 Hart）的预后意义。通过 Kaplan-Meier 分析绘制总生存期（OS）曲线。通过单因素和多因素分析确定预后因素。
单因素分析显示，所有分期系统对总生存期均有显著影响（p<0.05），但多因素分析显示，只有 TANIS-8 方案（p=0.008）和 Snyderman 方案（p=0.047）可预测 OS，而 UICC/AJCC 分期不能显著预测 OS（p=0.381）。
与其他基于 TNM 的分期系统相比，UICC/AJCC 分期不能提供显著的 OS 预测，而替代的分期系统，如 TANIS-8，则具有更高的预后价值。
