Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Histopathology. 2021 Sep;79(3):325-337. doi: 10.1111/his.14291. Epub 2020 Dec 14.
The 8th edition of the American Joint Committee on Cancer (AJCC) Staging introduced depth of invasion (DOI) into the pT category of oral cavity squamous cell carcinoma. However, we noted multiple practical obstacles in accurately measuring DOI histologically in our daily practice.
To compare the prognostic effects of DOI and tumour thickness (TT), a meticulous pathology review was conducted in a retrospective cohort of 293 patients with AJCC 7th edition pT1/T2 oral tongue squamous cell carcinoma. Overall survival (OS) and nodal metastasis rate at initial resection were the primary and secondary outcomes, respectively. We found that TT and DOI were highly correlated with a correlation coefficient of 0.984. The upstage rate was only 6% (18 of 293 patients) when using TT in the pT stage compared with using DOI. More importantly, DOI and TT, as well as pT stage using DOI and pT stage using TT, performed identically in predicting risk of nodal metastasis and OS.
We therefore propose to replace DOI, a complicated measurement with many challenges, with TT in the pT staging system.
第 8 版美国癌症联合委员会（AJCC）分期将浸润深度（DOI）纳入口腔鳞状细胞癌的 pT 分类。然而，我们在日常实践中注意到，在组织学上准确测量 DOI 存在多个实际障碍。
为了比较 DOI 和肿瘤厚度（TT）的预后效果，我们对 293 例 AJCC 第 7 版 pT1/T2 口腔舌鳞状细胞癌患者的回顾性队列进行了细致的病理复习。总生存（OS）和初始切除时的淋巴结转移率分别为主要和次要结局。我们发现 TT 和 DOI 高度相关，相关系数为 0.984。与使用 DOI 相比，仅使用 TT 时 pT 分期的升期率仅为 6%（293 例患者中的 18 例）。更重要的是，DOI 和 TT 以及使用 DOI 的 pT 分期和使用 TT 的 pT 分期在预测淋巴结转移和 OS 的风险方面表现相同。
因此，我们建议用 TT 替代 pT 分期系统中具有许多挑战的复杂测量 DOI。
