Incorporation of log odds of positive lymph nodes into the AJCC TNM classification improves prediction of survival in oral cancer.
Clin Otolaryngol
; 42(2): 425-432, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-27960043
ABSTRACT
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 OUTCOMEMEASURES:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Bucais
/
Carcinoma de Células Escamosas
/
Metástase Linfática
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Clin Otolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Taiwan