Discordance between Clinical and Pathological TNM Classifi cations in Patients with Oropharyngeal Cancer – Infl uence on Treatment and Prognosis

Kordač, Petr; Kalfeřt, David; Smatanová, Katarína; Laco, Ján; Vošmik, Milan; Čelakovský, Petr; Chrobok, Viktor

doi:10.14735/amko2016122

Cited by 3 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, we investigated the frequency, associated factors, and survival implications of clinicopathological stage discrepancies in oropharyngeal cancer using a database containing 7731 relevant cases. Previous institutional studies of 50 to several hundred patients have identified staging discrepancies in head and neck (H&N) cancers 11‐13,16‐22 . One previous database study of stage‐discordant oral cavity cancers exists but included only 379 cases 23 .…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore expected that clinical and pathological assessments of stage may disagree. Indeed, previous studies have observed discrepancies between clinical and pathological staging in head and neck cancers 11‐13 . Previous studies have suggested that up to half of patients with OPSCC are incorrectly clinically staged 13 .…”

mentioning

confidence: 99%

“…Indeed, previous studies have observed discrepancies between clinical and pathological staging in head and neck cancers. [11][12][13] Previous studies have suggested that up to half of patients with OPSCC are incorrectly clinically staged. 13 However, no large-scale study of stage discrepancy in head and neck cancers has been performed.…”

mentioning

confidence: 99%

“…[11][12][13] Previous studies have suggested that up to half of patients with OPSCC are incorrectly clinically staged. 13 However, no large-scale study of stage discrepancy in head and neck cancers has been performed.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Kılıç

Kilic

Shah

et al. 2017

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Objective To determine the frequency, associated factors, and prognosis of clinicopathologic stage discrepancy in oropharyngeal squamous cell carcinoma (OPSCC). Study Design Retrospective study using a national database. Setting National Cancer Database. Subjects and Methods Cases of OPSCC diagnosed between January 1, 2004, and December 31, 2013, with full clinical and pathologic staging information available were identified. Demographic, clinicopathologic, and treatment variables associated with overall stage discrepancy were identified by multivariate logistic regression analysis. Results In total, 7731 cases of OPSCC were identified. Overall stage discrepancy was present in 30.2% of cases (21.9% upstaging, 8.2% downstaging). A total of 13.1% of cases were T-upstaged, and 10.5% of cases were T-downstaged; 22.9% of cases were N-upstaged, and 8.6% of cases were N-downstaged. Upstaging by overall stage was associated with a high Charlson-Deyo score, high tumor grade, number of lymph nodes examined, and increasing tumor size. No factors were positively associated with downstaging. High tumor grade was negatively associated with downstaging. For stage II, III, and IVA tumors, upstaging was associated with poorer OS. Conclusion Clinicopathologic stage discrepancy is common in OPSCC and is likely attributable to insensitive clinical staging techniques as well as to intrinsic tumor biologic properties. Upstaging is associated with poorer prognosis, which is likely due to advancement of disease.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Kılıç

Kilic

Shah

et al. 2017

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

show abstract

“…Kordac et al. wiesen in ihrer Studie auch nach, dass sich in 53 % der Fälle nach Operation eine unterschiedliche TNM-Klassifikation ergab [ 31 ]. Gallo et al.…”

Section: Diskussionunclassified

Funktionelle Ergebnisse nach transmandibulärer Resektion und primärer Radiochemotherapie bei fortgeschrittenen Kopf-Hals-Plattenepithelkarzinomen

Knopf

Mansour

Hofauer

et al. 2020

HNO

View full text Add to dashboard Cite

Zusammenfassung Ziel der Arbeit In dieser Studie wurden die funktionellen Ergebnisse nach transmandibulärer Resektion und Rekonstruktion mittels mikrovaskulär anastomosiertem Radialistransplantat (TMR+Tx) gegenüber einer primären Radiochemotherapie (pRCT) bei fortgeschrittenen orophayngealen Plattenepithelkarzinomen (OPSCC) verglichen. Methoden Es erfolgte ein Vergleich zwischen 50 OPSCC-Patienten mit TMR+Tx und 50 OPSCC-Patienten mit pRCT. Die Wasserschluckzeit war als primärer Endpunkt definiert. Der Saxon-Test, die maxillomandibuläre Distanz, der Mallampati-Score, der Quotient aus Körpergröße zu Gewicht, eine nasale Penetration, das Vorhandensein einer Ernährungssonde/Tracheostomie sowie 4 validierte Fragebögen (Visuelle Analogskala zur Mundtrockenheit, Sicca VAS; MD Anderson Dysphagia Inventory, MDADI; Voice Handicap Index, VHI; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Head and Neck Cancer – 35 Items, QLQ-H&N35) dienten als sonstige Endpunkte zur Beurteilung der Funktion und Lebensqualität. Ergebnisse Die Gesamtkohorte an operierten Patienten zeigte eine erhöhte Rate an nasaler Penetration (p < 0,0001), was mit einer verlängerten Wasserschluckzeit verbunden war (p < 0,05). Durch eine modifizierte Rekonstruktion des Weichgaumens wurde die nasale Penetration in der chirurgisch therapierten Gruppe im Vergleich zur klassischen Rekonstruktion signifikant reduziert (p = 0,0001). Patienten mit pRCT litten signifikant stärker an einer Xerostomie (Saxon-Test) als Patienten nach TMR+Tx und Adjuvanz (p = 0,001). In den Fragebögen zur Funktionalität und Lebensqualität zeigte sich kein Unterschied zwischen den Gruppen. Schussfolgerung Die TMR+Tx mit modifizierter Rekonstruktion und adjuvante Therapie zeigte gegenüber der pRCT vergleichbare funktionelle Ergebnisse.

show abstract

Patterns of Discordance Between Clinical and Pathologic Stage in Head and Neck Cancer

Hondorp,

Punjabi,

Macias

et al. 2024

The Laryngoscope

View full text Add to dashboard Cite

ObjectiveTo enhance understanding in patterns of discordance between clinical and pathological T and N staging in multiple sites of head and neck squamous cell cancer.MethodsA retrospective cohort of 580 newly diagnosed and surgically treated head and neck squamous cell carcinoma patients from a single institution over a 10‐year period are presented. Clinical and pathologic staging are compared.ResultsNotably, 33% of cases had staging discordance. Overall Cohen's kappa agreement was κ = 0.55 (moderate agreement). Highly discordant site stages with κ < 0.45 included: T2 oral cavity, T2 oropharynx, T3 larynx, and N1 lymph node. T2‐4 oral cavity cancers were often overstaged, and more than one‐third of T3 larynx cancers were understaged. Highly concordant site stages with κ>0.65 included: T1 larynx, T4 oropharynx, N0 lymph node, and N3 lymph node.ConclusionThere exists a quantifiable and, in certain sites, clinically relevant pattern of discordance between clinical and pathologic staging. Tumor board multidisciplinary evaluation can highlight these discrepancies and aide in limiting effects on treatment decisions. However, discordant staging can affect the interpretation and application of prognostication, treatment, and data accuracy. Further investigation is warranted to improve clinical staging accuracy in areas of highest discordance.Level of Evidence3 Laryngoscope, 2024

show abstract

Discordance between Clinical and Pathological TNM Classifi cations in Patients with Oropharyngeal Cancer – Infl uence on Treatment and Prognosis

Cited by 3 publications

References 0 publications

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Funktionelle Ergebnisse nach transmandibulärer Resektion und primärer Radiochemotherapie bei fortgeschrittenen Kopf-Hals-Plattenepithelkarzinomen

Patterns of Discordance Between Clinical and Pathologic Stage in Head and Neck Cancer

Contact Info

Product

Resources

About