Is the new TNM (1997) the best system for predicting prognosis?

Abstract

In 1997, the U.I.C.C. (International Union against Cancer) modified the previous TNM stage grouping published in 1987. In the present study, TANIS and TNM '97 systems were compared in order to evaluate their prognostic ability. Data from 164 patients affected by primary squamous cell carcinoma cancers of the oral cavity (n=100) and oropharynx (n=64) were analyzed by means of survival analyses. Both systems showed a significant correlation with survival rate. TANIS yielded better results in association with the survival rate as compared with TNM '97.

Correlação entre os dados clínicos e histopatológicos dos casos de carcinoma espinocelular oral do Instituto Maranhense de Oncologia Aldenora Bello, em São Luís, MA

“…Divergindo desses resultados, Anneroth, Batsakis e Luna (4) relataram que houve correlação estatisticamente significativa entre a graduação histopatológica e o estadiamento clínico utilizando o sistema de graduação histopatológica de malignidade desenvolvido por Jakobsson et al Os nossos resultados também diferem dos de Costa et al (6) , que relataram haver correlação entre TNM e SGHM preconizado pela OMS a partir da análise de 120 casos de CEC oral. Também são divergentes dos de Costa, Araújo Júnior e Ramos (7) , que encontraram relação estatisticamente significante entre o estadiamento clínico TNM e os escores histológicos de malignidade obtidos no front de invasão tumoral.…”

A comparison of published head and neck stage groupings in carcinomas of the oral cavity

“…But such work should not only assess the adequacy of the current UICC/ AJCC staging scheme, it should also attempt to identify an alternative. The schemes most often tested against UICC/AJCC are TANIS 4,5,8,[10][11][12][13] and Hart. 8,9,12,14 On the basis of this previous work, it is not possible to reach any conclusions regarding an alternative to UICC/AJCC because only a subset of the alternative schemes were assessed, the study populations were often too small and/or nonrepresentative, and formal criteria for assessment were not defined.…”

“…Most of the previous work has focused on prognosis, or hazard discrimination, either by examining the spread of the group survival curves through visual inspection and/or the use of the log rank test and/or by quantifying the spread of the curves using the Cox proportional hazards model. [3][4][5][6][7][8][9][10][11][12][13][14] Although problems with heterogeneity of the TNM subgroups within some of the UICC groupings is also well recognized, to our knowledge, formal assessment of homogeneity, or hazard consistency, has only been done by our group. In this earlier work, we studied a regional cohort of head and neck patients and reported the p val-ues generated from sequential comparisons of the actuarial survival curves.…”

A comparison of published head and neck stage groupings in carcinomas of the tonsillar region

“…The schemes most often tested against UICC/AJCC are TANIS 5,6,9,[16][17][18][19]15,18,20 Based on this previous work, it is not possible to reach any conclusions regarding an alternative to UICC/AJCC because only a subset of the alternative schemes were assessed, the study populations were often too small and/or nonrepresentative, and formal criteria for assessment were not defined. Many of the alternate schemes presented here were developed because of dissatisfaction with the UICC-AJCC stage grouping scheme.…”