Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma
Objectives Depth of invasion (DOI) is the most important predictor for lymph node metastasis in early‐stage oral cancer. This study aims to investigate the effects of the different classifications of AJCC 7th and 8th on predicting lymph node metastasis and the optimal cutoff point for DOI predicting...
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| Veröffentlicht in: | Oral diseases 2023-05, Vol.29 (4), p.1542-1549 |
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| container_title | Oral diseases |
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| creator | Yu, Shun Yu, Zi‐Li Ye, Zi‐Wu Jia, Jun |
| description | Objectives
Depth of invasion (DOI) is the most important predictor for lymph node metastasis in early‐stage oral cancer. This study aims to investigate the effects of the different classifications of AJCC 7th and 8th on predicting lymph node metastasis and the optimal cutoff point for DOI predicting the lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC).
Materials and methods
We performed a retrospective study in 208 TSCC patients in early T stage without clinical or radiological signs of lymph node metastasis. Those patients were treated with elective neck dissection (END) between April 2019 and December 2020. And the relation between DOI and lymph node metastasis was analyzed.
Results
Metastases were found in 58 of 208 patients (27.88%). Of those 58 patients, the mean DOI was 8.311 mm compared to 5.425 mm in patients without metastases (p |
| doi_str_mv | 10.1111/odi.14178 |
| format | Article |
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Depth of invasion (DOI) is the most important predictor for lymph node metastasis in early‐stage oral cancer. This study aims to investigate the effects of the different classifications of AJCC 7th and 8th on predicting lymph node metastasis and the optimal cutoff point for DOI predicting the lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC).
Materials and methods
We performed a retrospective study in 208 TSCC patients in early T stage without clinical or radiological signs of lymph node metastasis. Those patients were treated with elective neck dissection (END) between April 2019 and December 2020. And the relation between DOI and lymph node metastasis was analyzed.
Results
Metastases were found in 58 of 208 patients (27.88%). Of those 58 patients, the mean DOI was 8.311 mm compared to 5.425 mm in patients without metastases (p < 0.0001). The receiver operating characteristic curve (ROC curve) showed an area under the curve of 0.7066 with the most optimal cutoff point on a DOI of 4.050 mm (sensitivity 86.21%, specificity 52%). Linear regression analysis (1 mm ≤ DOI ≤6 mm) revealed that a DOI ≥ 3.211 mm predicated an incidence of occult lymph node metastasis greater than 20%. Regional metastases were found in 12.82% of patients with DOI ≤ 4.0 mm. Within the entire cohort, 60 cases (28.85%) got upgraded with respect to T stage. No tumor underwent downstaging.
Conclusion
The 8th edition provides better lymph node metastasis prediction for TSCC than the 7th. And DOI is a poor predictor for regional metastasis in patients with early T stage clinically node‐negative TSCC. END in patients with early‐stage TSCC should be performed in patients with DOI ≥ 3.211 mm.</description><identifier>ISSN: 1354-523X</identifier><identifier>EISSN: 1601-0825</identifier><identifier>DOI: 10.1111/odi.14178</identifier><identifier>PMID: 35247026</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Carcinoma, Squamous Cell - pathology ; depth of invasion ; Humans ; lymph node metastasis ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic Metastasis - pathology ; Lymphatic system ; Metastases ; Metastasis ; Neoplasm Staging ; Oral cancer ; Oral carcinoma ; Prognosis ; Retrospective Studies ; Squamous cell carcinoma ; Tongue ; Tongue Neoplasms - pathology ; Tongue Neoplasms - surgery ; tongue squamous cell cancer</subject><ispartof>Oral diseases, 2023-05, Vol.29 (4), p.1542-1549</ispartof><rights>2022 Wiley Periodicals LLC</rights><rights>2022 Wiley Periodicals LLC.</rights><rights>2023 Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-feb5cd9da580983a0237717127ddec54db48e98c6d82ec3067d7c6392a8870b03</citedby><cites>FETCH-LOGICAL-c3538-feb5cd9da580983a0237717127ddec54db48e98c6d82ec3067d7c6392a8870b03</cites><orcidid>0000-0003-0728-8564 ; 0000-0002-9593-5567</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fodi.14178$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fodi.14178$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35247026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Shun</creatorcontrib><creatorcontrib>Yu, Zi‐Li</creatorcontrib><creatorcontrib>Ye, Zi‐Wu</creatorcontrib><creatorcontrib>Jia, Jun</creatorcontrib><title>Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma</title><title>Oral diseases</title><addtitle>Oral Dis</addtitle><description>Objectives
Depth of invasion (DOI) is the most important predictor for lymph node metastasis in early‐stage oral cancer. This study aims to investigate the effects of the different classifications of AJCC 7th and 8th on predicting lymph node metastasis and the optimal cutoff point for DOI predicting the lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC).
Materials and methods
We performed a retrospective study in 208 TSCC patients in early T stage without clinical or radiological signs of lymph node metastasis. Those patients were treated with elective neck dissection (END) between April 2019 and December 2020. And the relation between DOI and lymph node metastasis was analyzed.
Results
Metastases were found in 58 of 208 patients (27.88%). Of those 58 patients, the mean DOI was 8.311 mm compared to 5.425 mm in patients without metastases (p < 0.0001). The receiver operating characteristic curve (ROC curve) showed an area under the curve of 0.7066 with the most optimal cutoff point on a DOI of 4.050 mm (sensitivity 86.21%, specificity 52%). Linear regression analysis (1 mm ≤ DOI ≤6 mm) revealed that a DOI ≥ 3.211 mm predicated an incidence of occult lymph node metastasis greater than 20%. Regional metastases were found in 12.82% of patients with DOI ≤ 4.0 mm. Within the entire cohort, 60 cases (28.85%) got upgraded with respect to T stage. No tumor underwent downstaging.
Conclusion
The 8th edition provides better lymph node metastasis prediction for TSCC than the 7th. And DOI is a poor predictor for regional metastasis in patients with early T stage clinically node‐negative TSCC. END in patients with early‐stage TSCC should be performed in patients with DOI ≥ 3.211 mm.</description><subject>Carcinoma, Squamous Cell - pathology</subject><subject>depth of invasion</subject><subject>Humans</subject><subject>lymph node metastasis</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Neoplasm Staging</subject><subject>Oral cancer</subject><subject>Oral carcinoma</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Squamous cell carcinoma</subject><subject>Tongue</subject><subject>Tongue Neoplasms - pathology</subject><subject>Tongue Neoplasms - surgery</subject><subject>tongue squamous cell cancer</subject><issn>1354-523X</issn><issn>1601-0825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctKAzEUhoMoXqoLX0ACbnQxNpfJJLMs451CNwruQppkbGQmaSczSt_eaKsLwWxOOHx8_JwfgFOMrnB642DcFc4xFzvgEBcIZ0gQtpv-lOUZI_TlABzF-IYQ5iUl--CAMpJzRIpD0FShXapO9e7dwtgPZg2Dh7pRMbra6bQPPsJQw8ljVUHRL6DyBvI0nYf9wsJlQqzvI_xwadkH_zok0WpQbRgi1LZpoFaddj606hjs1aqJ9mQ7R-D59uapus-ms7uHajLNNGVUZLWdM21Ko5hApaAKEco55phwY6xmuZnnwpZCF0YQqykquOG6oCVRQnA0R3QELjbeZRdWg429bF38iqK8TakkKWiBWbpAkdDzP-hbGDqf0kkiEClzzghJ1OWG0l2IsbO1XHauVd1aYiS_KpCpAvldQWLPtsZh3lrzS_7cPAHjDfDhGrv-3yRn1w8b5SeaXI9L</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Yu, Shun</creator><creator>Yu, Zi‐Li</creator><creator>Ye, Zi‐Wu</creator><creator>Jia, Jun</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0728-8564</orcidid><orcidid>https://orcid.org/0000-0002-9593-5567</orcidid></search><sort><creationdate>202305</creationdate><title>Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma</title><author>Yu, Shun ; Yu, Zi‐Li ; Ye, Zi‐Wu ; Jia, Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-feb5cd9da580983a0237717127ddec54db48e98c6d82ec3067d7c6392a8870b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Carcinoma, Squamous Cell - pathology</topic><topic>depth of invasion</topic><topic>Humans</topic><topic>lymph node metastasis</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Neoplasm Staging</topic><topic>Oral cancer</topic><topic>Oral carcinoma</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Squamous cell carcinoma</topic><topic>Tongue</topic><topic>Tongue Neoplasms - pathology</topic><topic>Tongue Neoplasms - surgery</topic><topic>tongue squamous cell cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Shun</creatorcontrib><creatorcontrib>Yu, Zi‐Li</creatorcontrib><creatorcontrib>Ye, Zi‐Wu</creatorcontrib><creatorcontrib>Jia, Jun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Oral diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Shun</au><au>Yu, Zi‐Li</au><au>Ye, Zi‐Wu</au><au>Jia, Jun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma</atitle><jtitle>Oral diseases</jtitle><addtitle>Oral Dis</addtitle><date>2023-05</date><risdate>2023</risdate><volume>29</volume><issue>4</issue><spage>1542</spage><epage>1549</epage><pages>1542-1549</pages><issn>1354-523X</issn><eissn>1601-0825</eissn><abstract>Objectives
Depth of invasion (DOI) is the most important predictor for lymph node metastasis in early‐stage oral cancer. This study aims to investigate the effects of the different classifications of AJCC 7th and 8th on predicting lymph node metastasis and the optimal cutoff point for DOI predicting the lymph node metastasis in patients with tongue squamous cell carcinoma (TSCC).
Materials and methods
We performed a retrospective study in 208 TSCC patients in early T stage without clinical or radiological signs of lymph node metastasis. Those patients were treated with elective neck dissection (END) between April 2019 and December 2020. And the relation between DOI and lymph node metastasis was analyzed.
Results
Metastases were found in 58 of 208 patients (27.88%). Of those 58 patients, the mean DOI was 8.311 mm compared to 5.425 mm in patients without metastases (p < 0.0001). The receiver operating characteristic curve (ROC curve) showed an area under the curve of 0.7066 with the most optimal cutoff point on a DOI of 4.050 mm (sensitivity 86.21%, specificity 52%). Linear regression analysis (1 mm ≤ DOI ≤6 mm) revealed that a DOI ≥ 3.211 mm predicated an incidence of occult lymph node metastasis greater than 20%. Regional metastases were found in 12.82% of patients with DOI ≤ 4.0 mm. Within the entire cohort, 60 cases (28.85%) got upgraded with respect to T stage. No tumor underwent downstaging.
Conclusion
The 8th edition provides better lymph node metastasis prediction for TSCC than the 7th. And DOI is a poor predictor for regional metastasis in patients with early T stage clinically node‐negative TSCC. END in patients with early‐stage TSCC should be performed in patients with DOI ≥ 3.211 mm.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35247026</pmid><doi>10.1111/odi.14178</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0728-8564</orcidid><orcidid>https://orcid.org/0000-0002-9593-5567</orcidid></addata></record> |
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| subjects | Carcinoma, Squamous Cell - pathology depth of invasion Humans lymph node metastasis Lymph nodes Lymph Nodes - pathology Lymphatic Metastasis - pathology Lymphatic system Metastases Metastasis Neoplasm Staging Oral cancer Oral carcinoma Prognosis Retrospective Studies Squamous cell carcinoma Tongue Tongue Neoplasms - pathology Tongue Neoplasms - surgery tongue squamous cell cancer |
| title | Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma |
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