Stage Grouping Reliability: TNM '97 versus TANIS in Laryngeal Cancer

Abstract

Both systems showed a significant correlation with the survival rate. TANIS advanced subcategories were better correlated with the mortality rate than TNM stages IVa and IVb. Again, in the final statistical model, TANIS was more highly correlated with survival rate than TNM.

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.…”

TNM‐based stage groupings in head and neck cancer: Application in cancer of the hypopharynx

“…The relative strengths of the TNM classification for head and neck cancers have been reviewed by Piccirillo3 and Lydiatt et al,4 who noted simplicity, universal acceptance, longevity, user‐friendliness, and cost‐effectiveness. Numerous authors have presented assessments of the performance the TNM stage grouping system as predictors of survival for the head and neck cancer sites (oral cavity,5–7 larynx,8, 9 oropharynx,10–14 all sites15–18); although all concluded that the TNM stage created groups that were statistically successful predictors of survival, all reported that 1 or more stage grouping systems were better predictors. Many authors have proposed changes to both TNM categories and the stage groups for the head and neck sites, but no substantial changes to stage groups have been forthcoming.…”