CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S141-S142
DOI: 10.1055/s-0038-1640201
Abstracts
Onkologie: Oncology

Does the new TNM classification improve the estimation of prognosis for oropharyngeal carcinomas?

S Wiegand
1   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
,
J Freitag
2   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
,
T Wald
2   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
,
A Dietz
2   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
,
M Kolb
2   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
,
G Wichmann
2   Klinik für Hals-, Nasen-, Ohrenheilkunde, Leipzig
› Author Affiliations
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    Introduction:

    The classification of oropharyngeal carcinomas (OPSCC) has been fundamentally changed in the 8th edition of the TNM classification (TNM 2017) compared to the 7th edition (TMN 2010). The aim of this study was to compare the prognostic accuracy of TNM 2010 and TNM 2017 for OPSCC in our own patient cohort.

    Methods:

    Retrospective analysis of overall (OS) and tumor specific survival (TSS) as well as prognostic accuracy of TNM 2010 and 2017 in a predominantly surgically treated cohort of 415 patients with OPSCC stage III-IVB (according to TNM 2010).

    Results:

    According to TNM 2010, 58 patients (14%) were in stage III, 308 (74.2%) in IVA, and 49 (11.8%) in IVB; according to TNM 2017, 30 patients (7.2%) were in stage I, 26 (6.3%) in II, 74 (17.8%) in III, 162 (39.0%) in IVA and 123 (29.6%) in IVB. According to Kaplan-Meier estimates, TNM 2010 accurately discriminates stage III, IVA and IVB (75% TSS 48.6, 28.2 and 10.6 months, p = 0.0002; median OS 70.7, 68.4 and 21.2 months, p = 0.00002). TNM 2017 fails to significantly discriminate III, IVA and IVB in the analyzed cohort (75% TSS 28.2, 17.3 and 29.0 months, median OS 68.3, 53.9 and 41.9 months), but shows a significantly better prognosis for stage I and stage II. The poor discrimination of OS and TSS in TNM 2017 is caused by a redistribution of 28 p16+ T4 OPSCC in stage III and 84 patients with extracapsular extension (ECE) of neck nodes (now pN3b) in IVB.

    Conclusion:

    In p16+ patients, TNM 2017 predicts improved survival in stage I and II but is suboptimal for survival estimation in T4 OPSCC. The redistribution of patients with ECE to stage IVB does not accurately reflect their survival in the analyzed patient cohort.


    #

    No conflict of interest has been declared by the author(s).

    Prof. Dr. Susanne Wiegand
    Klinik für Hals-, Nasen-, Ohrenheikundel,
    Liebigstraße 10 – 14, 04103,
    Leipzig

    Publication History

    Publication Date:
    18 April 2018 (online)

    © 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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