重新评估口腔鳞状细胞癌的TNM分期系统：一项与年龄相关的预后分析。
Reappraising the TNM staging system for oral cavity squamous cell carcinoma: an age-related prognosis analysis.
作者信息
Ritter Amit, Yosefof Eyal, Edri Nofar, Kurman Noga, Bachar Gideon, Shpitzer Thomas, Mizrachi Aviram
机构信息
Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Eur Arch Otorhinolaryngol. 2025 Apr 25. doi: 10.1007/s00405-025-09385-x.
OBJECTIVE
Research on age and prognosis for oral cavity squamous cell carcinomas (OSCCs) has shown inconsistent results. We aimed to establish age as an independent prognostic factor and determine an age cutoff for staging in OSCC.
METHODS
Electronic records were reviewed for all OSCC patients treated between 2000 and 2020.
RESULTS
The study involved 250 patients, identifying a mortality cutoff age of 65 through Receiver Operating Characteristic curve analysis (sensitivity 77%, specificity 49%). Patients ≥ 65 had lower survival rates for early-stage (TNM I-II; 63.5% vs. 96%, p < 0.001) and advanced-stage (TNM III-IV; 37.5% vs. 62%, p = 0.011) diseases. A proposed age-based TNM staging system categorized ≥ 65 as Stage III/IV, with comparable survival rates confirmed in a revised analysis.
CONCLUSION
The study identifies age, with a 65-year cutoff, as an independent prognostic factor in OSCC and highlights its role in improving current staging systems.
LEVEL OF EVIDENCE
III.
目的
关于口腔鳞状细胞癌（OSCC）年龄与预后的研究结果并不一致。我们旨在将年龄确立为独立的预后因素，并确定OSCC分期的年龄临界值。
方法
回顾了2000年至2020年间接受治疗的所有OSCC患者的电子记录。
结果
该研究纳入了250例患者，通过受试者工作特征曲线分析确定死亡临界年龄为65岁（灵敏度77%，特异度49%）。年龄≥65岁的患者在早期（TNM I-II期；63.5%对96%，p<0.001）和晚期（TNM III-IV期；37.5%对62%，p=0.011）疾病中的生存率较低。一种提议的基于年龄的TNM分期系统将年龄≥65岁归类为III/IV期，在修订分析中证实了类似的生存率。
结论
该研究确定年龄（临界值为65岁）为OSCC的独立预后因素，并强调了其在改进当前分期系统中的作用。
证据级别
III级。
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