美国癌症联合委员会第 8 版 TNM 分期系统在早期口腔舌癌患者中的预后表现。
Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer.
机构信息
Departments of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
Head and Neck Surgery and the Laboratory for Head and Neck Cancer Research, Houston Methodist research institute, Houston Methodist hospital, Houston, Texas.
出版信息
Head Neck. 2019 May;41(5):1270-1276. doi: 10.1002/hed.25553. Epub 2018 Dec 10.
BACKGROUND
The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC).
METHODS
Overall survival (OS) and disease-specific survival (DSS) of 244 patients were calculated using the Kaplan-Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression.
RESULTS
Sixty-two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition.
CONCLUSION
The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.
背景
美国癌症联合委员会（AJCC）第 8 版口腔癌分期系统纳入了病理特征。我们旨在评估这些变化是否能更好地对早期口腔舌鳞状细胞癌（OTSCC）患者进行风险分层。
方法
采用 Kaplan-Meier 法计算 244 例患者的总生存率（OS）和疾病特异性生存率（DSS）。采用 Cox 比例风险回归进行逐步选择的多变量分析。
结果
62 例（25%）患者按第 8 版分期升级。多变量分析显示，第 8 版 AJCC 分期系统的总分期而非第 7 版分期是 OS 和 DSS 的显著预测因素。与第 7 版相比，第 8 版 AJCC 的 Akaike 信息准则和一致性指数值更低。
结论
第 8 版 AJCC 允许更好地对 OTSCC 患者进行风险分层，并为以前被认为低风险的患者提供更精确的咨询。
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