Parotid cancer: Impact of changes from the 1997 to the 2002 American Joint Committee on Cancer classification on outcome prediction

Parotid cancer: Impact of changes from the 1997 to the 2002 American Joint Committee on Cancer classification on outcome prediction

BACKGROUND. The TNM classification [American Joint Committee on Cancer (AJCC)] of salivary gland cancer was revised again in 2002. In the present study, the outcome prediction of the new TNM system was compared with the old 1997 TNM system in 202 patients with primary parotid cancer. METHODS. All pa...

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Bibliographic Details
Published in:Cancer Vol. 113; no. 4; pp. 758 - 764
Main Authors: Schroeder, Ursula, Groppe, Daniela, Mueller, Rolf‐Peter, Guntinas‐Lichius, Orlando
Format: Journal Article
Language:English
Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15-08-2008
Wiley-Liss
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Child
Disease-Free Survival
disease‐free survival rate
Female
Humans
major salivary gland carcinoma
Male
Medical sciences
Middle Aged
Neoplasm Staging
Otorhinolaryngology. Stomatology
parotid gland carcinoma
Parotid Neoplasms - classification
Parotid Neoplasms - mortality
Prognosis
Regression Analysis
Retrospective Studies
TNM classification
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
disease-free survival rate
Carcinoma
Prognosis
Parotid gland
TNM classification
Digestive system
Stomatology
Salivary gland
Malignant tumor
TNM-System
Parotid gland cancer
major salivary gland carcinoma
Salivary gland disease
Cancerology
Classification
parotid gland carcinoma
Predictive factor
Disease free survival
Cancer
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Summary:BACKGROUND. The TNM classification [American Joint Committee on Cancer (AJCC)] of salivary gland cancer was revised again in 2002. In the present study, the outcome prediction of the new TNM system was compared with the old 1997 TNM system in 202 patients with primary parotid cancer. METHODS. All patients treated from 1986 to 2006 were reclassified in both TNM systems. Disease‐free survival (DFS) rates were calculated. The prognostic validity of both the TNM system and other factors were analyzed univariately (log‐rank test) and multivariately (Cox regression). RESULTS. AJCC TNM stage changes from 1997 to 2002 altered the disease staging in 35% of the patients. Concerning DFS, the new TNM 2002 staging allowed significantly better separation of stage III, but not of stage I versus stage II. The TNM 2002 staging was the most powerful predictor for DFS according to multivariate analysis. The 1997 system showed no independent significance. The subclassification of the new stage IV was not satisfactory; no clear distinction of IVA versus III, and IVA versus IVB was possible. CONCLUSIONS. The TNM 2002 staging is more valid than the 1997 system, but a significant problem was observed in separating stage I from stage II, and within the stage IV subgroups. Cancer 2008. © 2008 American Cancer Society. The TNM 2002 staging system is more valid than the 1997 system for parotid cancer. However, the next TNM revision needs to solve the significant problem of separating stage I and stage II, and the subgroups within stage IV.
Bibliography:Fax: (011) 49 3641‐935‐129
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ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.23626