Berpan Aniwat
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit, Bangkok, 10300, Thailand.
Eur Arch Otorhinolaryngol. 2025 Jun 2. doi: 10.1007/s00405-025-09489-4.
To compare overall survival (OS) differences across 11 different staging classifications.
Patient data were retrospectively collected. OS curves were estimated by Kaplan-Meier method. Hazard ratios (HR) were calculated by Cox regression. Concordance between HR of each system was evaluated by C-index. Absolute net reclassification improvement (NRI) was performed.
Thirty-five patients fitted study criteria with median follow-up of 27.3 months. 80% were diagnosed with squamous cell carcinoma. 14.3% had ECOG > 1. Eighteen patients underwent surgery, while 31 patients received radiotherapy. For AJCC 8th edition cutaneous carcinoma of the head and neck, 3-year OS of stage 1-3 and 4 was 26.7% (median OS of 0.8 years) and 64.1% (median OS of 4.3 years) (HR 0.33; 95%CI 0.09-1.2). 3-year OS of T1-3 and T4 in modified Pittsburgh classification were 65% and 55.4% with median OS of not reached and 3.1 years (HR 1.86; 95%CI 0.66-5.23). Regarding Kinney system, patients with stage 1-2 and 3 had 3-year OS of 67.1% and 45.5%, while median OS was 4.7 years and 1 year (HR 1.94; 95%CI 0.75-4.97). C-indices were 0.577, 0.523 and 0.569. NRI comparing Kinney with modified Pittsburgh classifications was 2.86%.
Kinney's may offer improved prognostic accuracy compared to other classifications.
比较11种不同分期分类的总生存期（OS）差异。
回顾性收集患者数据。采用Kaplan-Meier法估计OS曲线。通过Cox回归计算风险比（HR）。用C指数评估各系统HR之间的一致性。进行绝对净重新分类改善（NRI）分析。
35例患者符合研究标准，中位随访时间为27.3个月。80%被诊断为鳞状细胞癌。14.3%的患者东部肿瘤协作组（ECOG）体能状态评分>1。18例患者接受了手术，31例患者接受了放疗。对于美国癌症联合委员会（AJCC）第8版头颈部皮肤癌，1-3期和4期的3年总生存率分别为26.7%（中位总生存期为0.8年）和64.1%（中位总生存期为4.3年）（HR 0.33；95%置信区间0.09-1.2）。改良匹兹堡分类中T1-3期和T4期的3年总生存率分别为65%和55.4%，中位总生存期未达到和3.1年（HR 1.86；95%置信区间0.66-5.23）。关于金尼系统，1-2期和3期患者的3年总生存率分别为67.1%和45.5%，而中位总生存期分别为4.7年和1年（HR 1.94；95%置信区间0.75-4.97）。C指数分别为0.577、0.523和
