第 8 版 AJCC 口腔鳞状细胞癌分期——优于第 7 版 AJCC 吗？
AJCC 8th Edition oral cavity squamous cell carcinoma staging - Is it an improvement on the AJCC 7th Edition?
机构信息
Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; UWA Medical School, University of Western Australia, Nedlands, Western Australia, Australia.
UWA Medical School, University of Western Australia, Nedlands, Western Australia, Australia; Royal Perth Hospital, Perth, Western Australia, Australia.
出版信息
Oral Oncol. 2018 Jul;82:23-28. doi: 10.1016/j.oraloncology.2018.04.018. Epub 2018 May 10.
OBJECTIVES
To explore the prognostic and discriminatory ability of the AJCC 8th Edition Oral Cavity cancer staging in a non-North American population, and compare it to the previously used AJCC 7th Edition.
MATERIALS AND METHODS
Retrospective chart review was performed at a tertiary referral Otolaryngology, Head Neck and Skull Base Department in Australia, from June 2002 to June 2017. Oral cavity squamous cell carcinoma cases were staged according to AJCC 8th Edition, which was compared to AJCC 7th Edition staging, for disease-free survival (DFS) and overall survival (OS). DFS and OS were analysed using Kaplan-Meier curves.
RESULTS
There were 118 patients treated for OSCC, with an average age of 61 years, 63% were male. Overall survival grouped by stage demonstrated statistically significant discrimination between cancer stages using both the AJCC 7th and AJCC 8th Editions. AJCC 7th Edition did not discriminate between stages for DFS. Conversely, AJCC 8th Edition did statistically significantly discriminate for DFS (p = 0.0002). The DFS for both Stage 4a and 4b was significantly worse than cases in Stage 1. AJCC 8th Edition T stage was statistically significantly related to DFS (p = 0.0199), while the AJCC 7th Edition T stage was not.
CONCLUSION
The AJCC Cancer Staging Manual 8th Edition includes both the depth of primary tumour invasion and extracapsular extension of lymph node metastases. The AJCC 8th Edition OSCC staging system showed improved disease-free survival discrimination between overall stages and between T categories, while AJCC 7th Edition did not.
目的
探索 AJCC 第 8 版口腔癌分期在非北美人群中的预后和区分能力，并将其与之前使用的 AJCC 第 7 版进行比较。
材料和方法
对澳大利亚一家三级转诊耳鼻喉科、头颈部和颅底科 2002 年 6 月至 2017 年 6 月的病历进行回顾性图表审查。口腔鳞状细胞癌病例根据 AJCC 第 8 版进行分期，与 AJCC 第 7 版分期进行比较，评估无病生存率（DFS）和总生存率（OS）。DFS 和 OS 采用 Kaplan-Meier 曲线进行分析。
结果
共有 118 例接受 OSCC 治疗的患者，平均年龄为 61 岁，男性占 63%。使用 AJCC 第 7 版和 AJCC 第 8 版分期，OS 总体生存率分组显示癌症分期之间存在统计学显著差异。AJCC 第 7 版不能区分 DFS 分期。相反，AJCC 第 8 版在统计学上显著区分了 DFS（p=0.0002）。4a 和 4b 期的 DFS 明显差于 1 期的病例。AJCC 第 8 版 T 分期与 DFS 有统计学显著相关性（p=0.0199），而 AJCC 第 7 版 T 分期则没有。
结论
AJCC 癌症分期手册第 8 版既包括原发肿瘤浸润深度，也包括淋巴结转移的包膜外扩展。AJCC 第 8 版 OSCC 分期系统在总体分期和 T 分类之间显示出更好的无病生存率区分能力，而 AJCC 第 7 版则没有。
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