Neoplasma. 2017;64(2):305-310. doi: 10.4149/neo_2017_219.
The goals of this retrospective cohort study were to compare the results of clinical and pathological TNM staging in patients with laryngeal squamous cell carcinoma and to determine the impact of the discordance on prognosis and treatment results. A total of 124 patients with laryngeal cancer, primarily indicated for surgical treatment, were enrolled. The concordance or discordance between the clinical and pathological staging was compared with the frequency of cancer relapse and disease-specific survival. Other potential prognostic factors, like age, the stage and location of the primary tumor, the status of neck lymph nodes, histological margins, and an indication for postoperative radiotherapy, were also evaluated. A disparity in at least one component of TNM staging was found in 40 patients (32%). The discordance had significant negative influence on both disease-free survival (DSF) and disease-specific survival (DSS). Other significant negative prognostic factors were the stage of the primary tumor, nodal status and postoperative radiotherapy. Our results indicate that the discordance between clinical and pathological staging affects the results of cancer treatment significantly. Some improvement can be probably achieved with higher preoperative diagnostic method accuracy.
本回顾性队列研究的目的是比较喉鳞状细胞癌患者的临床和病理 TNM 分期结果，并确定分期不一致对预后和治疗结果的影响。共纳入 124 例主要接受手术治疗的喉癌患者。比较了临床和病理分期的一致性或不一致性与癌症复发和疾病特异性生存率的频率。还评估了其他潜在的预后因素，如年龄、原发肿瘤的分期和位置、颈部淋巴结状态、组织学切缘以及术后放疗的指征。在 40 名患者（32%）中发现至少一个 TNM 分期成分存在差异。分期不一致对无病生存率（DFS）和疾病特异性生存率（DSS）均有显著的负面影响。其他显著的负性预后因素包括原发肿瘤的分期、淋巴结状态和术后放疗。我们的结果表明，临床和病理分期之间的不一致会显著影响癌症治疗的结果。通过提高术前诊断方法的准确性，可能会有一定程度的改善。
