Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
Anticancer Res. 2024 Apr;44(4):1703-1710. doi: 10.21873/anticanres.16969.
BACKGROUND/AIM: The American Joint Committee on Cancer (AJCC) staging 8th edition introduced major changes in the TNM staging of oropharyngeal squamous cell carcinoma (OPSCC) based on the human papillomavirus (HPV) status. This study aimed to observe how well the AJCC staging 8 edition precisely discriminates survival outcomes in patients with HPV-associated OPSCC using a large population database.
Using the Surveillance, Epidemiology, and End Results database between 2010 and 2016, 7,448 patients with HPV-associated OPSCC were enrolled. Patients diagnosed with OPSCC and tested positive for HPV with information on the TNM staging according to the AJCC staging 7th edition were selected. Next, T-, N-, and clinical staging were reconstructed based on the AJCC staging 8th edition. Survival probabilities in both AJCC staging 7 and 8 editions were estimated and compared.
Most patients (93.44%) were down-staged from the 7 to the 8 edition. The AJCC staging 8 edition showed more discriminatory power in predicting survival of patients with HPV-associated OPSCC than the AJCC staging 7 edition, regardless of the primary subsites. Additionally, clinical stage I patients with HPV-associated OPSCC according to the AJCC 8 edition showed better prognosis in case of high T staging than high N staging. Clinical staging according to the AJCC 8 edition compared to that of the 7 edition was an independent prognostic factor in patients with HPV-associated OPSCC.
This study emphasizes the advantages of the new classification system for discriminating survival in HPV-associated OPSCC according to various factors.
背景/目的：第 8 版美国癌症联合委员会（AJCC）分期系统根据人乳头瘤病毒（HPV）状态，对口咽鳞状细胞癌（OPSCC）的 TNM 分期进行了重大修改。本研究旨在利用大型人群数据库观察 AJCC 第 8 版在预测 HPV 相关 OPSCC 患者生存结局方面的精确性。
使用 2010 年至 2016 年期间的监测、流行病学和最终结果（SEER）数据库，共纳入 7448 例 HPV 相关 OPSCC 患者。选择 OPSCC 患者，HPV 检测阳性，且根据 AJCC 第 7 版分期有 TNM 分期信息的患者。然后，根据 AJCC 第 8 版重建 T、N 和临床分期。估计并比较了 AJCC 第 7 版和第 8 版的生存概率。
大多数患者（93.44%）从第 7 版降期至第 8 版。与 AJCC 第 7 版相比，无论原发部位如何，AJCC 第 8 版在预测 HPV 相关 OPSCC 患者生存方面具有更强的区分能力。此外，根据 AJCC 第 8 版，HPV 相关 OPSCC 的临床 I 期患者，T 分期高的预后优于 N 分期高的患者。与第 7 版相比，根据 AJCC 第 8 版进行的临床分期是 HPV 相关 OPSCC 患者的独立预后因素。
本研究强调了新分类系统在根据多种因素区分 HPV 相关 OPSCC 患者生存方面的优势。
