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Incorporation of log odds of positive lymph nodes into the AJCC TNM classification improves prediction of survival in oral cancer.
Lee, C-C; Lin, Y-S; Kang, B-H; Chang, K-P; Chi, C-C; Lin, M-Y; Su, H-H; Chang, T-S; Chen, H-C; Chen, P-C; Huang, W-L; Huang, C-I; Chou, P; Yang, C-C.
Afiliación
  • Lee CC; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Lin YS; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
  • Kang BH; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
  • Chang KP; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Chi CC; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
  • Lin MY; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
  • Su HH; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Chang TS; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
  • Chen HC; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
  • Chen PC; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Huang WL; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
  • Huang CI; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
  • Chou P; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Yang CC; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Clin Otolaryngol ; 42(2): 425-432, 2017 Apr.
Article en En | MEDLINE | ID: mdl-27960043
OBJECTIVES: To assess the prognostic performance of a new N classification that incorporates the log odds of positive lymph nodes (LODDS) into the routinely used pathological N classification for oral squamous cell carcinoma (OSCC) patients. DESIGN: Retrospective cohort study utilising LODDS into pN category was performed, and the AJCC TNM stage and T-New N-M stage were compared with respect to 5-year disease-specific survival (DSS) rates. The discriminability was evaluated from the linear trend chi-square test, Akaike information criterion (AIC) and Harrell's c-statistic. SETTING: Medical centrer in Taiwan. PARTICIPANTS: A total of 463 patients received primary surgery and neck dissection between 2004 and 2013 for OSCC. MAIN OUTCOME MEASURES: The discriminability for 5-year DSS rates. RESULTS: The median follow-up period was 54 months, the mean patient age was 54 ± 11 years and 428 patients (92.4%) were male. The patients with higher LODDS had worse 5-year DSS rates. Incorporation of LODDS into the prognostic model based on the seventh edition of the TNM classification significantly improved discriminative performance for 5-year DSS with a lower AIC (1883 versus 1897), and higher prediction accuracy (Harrell's c-statistic: 0.768 versus 0.764). CONCLUSIONS: By utilising a merger of the LODDS and pN classifications to create a new N classification has better discriminatory and predictive ability than pathological TNM staging and could help identify high-risk patients for intense adjuvant therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Carcinoma de Células Escamosas / Metástasis Linfática Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Clin Otolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Carcinoma de Células Escamosas / Metástasis Linfática Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Clin Otolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido