Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Int J Clin Oncol. 2018 Oct;23(5):844-850. doi: 10.1007/s10147-018-1276-5. Epub 2018 Apr 19.
The revised 8th edition of the AJCC/UICC staging system was released in January 2017, and depth of invasion (DOI) was added to the new criteria for T classification in oral cavity cancer. In this study, we evaluated whether the 8th edition presents the prognosis and risk of nodal metastasis in patients with squamous cell carcinoma of tongue more accurately than did the 7th edition.
The data for 112 patients were obtained and reclassified based on the criteria presented in the 8th edition.
Seven patients previously staged as T1 based on the criteria in the 7th edition were reclassified as T2 based on the 8th edition, while 19 T2 patients were reclassified as T3, and 9 T4a patients were reclassified as T3. T3 in the 8th edition represents a homogenous population showing the same prognosis, while T2 in the 8th edition represents a heterogenous population. Nodal metastasis was significantly correlated with T classification in both editions and DOI. However, neither the T classification in the 7th or 8th edition, nor DOI could predict the probability of potential nodal metastasis in patients with cN0 disease.
The classification on T3 in the 8th edition can be seen as reasonable with regard to prognosis. Nodal metastasis was significantly correlated with T classification and DOI; however, the probability of subsequent nodal metastasis in patients with T2N0 was almost same for the criteria in the 7th and 8th editions, therefore, the same careful management as before is required for patients with N0 disease.
AJCC/UICC 分期系统第 8 版于 2017 年 1 月发布，口腔癌 T 分期标准中新加入了肿瘤侵犯深度（DOI）这一标准。本研究旨在评估第 8 版是否比第 7 版更准确地预测舌鳞癌患者的预后和淋巴结转移风险。
我们选取了 112 例患者的数据，根据第 8 版的标准进行重新分期。
7 例原 7 版 T1 期患者根据第 8 版标准被重新分类为 T2 期，19 例 T2 期患者被重新分类为 T3 期，9 例 T4a 期患者被重新分类为 T3 期。第 8 版 T3 期代表预后相同的同质人群，而第 8 版 T2 期则代表异质人群。在两个分期版本中，淋巴结转移均与 T 分期和 DOI 显著相关。然而，无论是第 7 版还是第 8 版的 T 分期，还是 DOI，都无法预测 cN0 患者潜在淋巴结转移的概率。
第 8 版 T3 期的分类在预测预后方面是合理的。淋巴结转移与 T 分期和 DOI 显著相关，但第 7 版和第 8 版的 T2N0 患者发生淋巴结转移的概率几乎相同，因此对于 N0 疾病的患者，仍需进行与以往相同的仔细管理。
