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Reappraising the TNM staging system for oral cavity squamous cell carcinoma: an age-related prognosis analysis
Amit Ritter1,2, Eyal Yosefof3,4, Nofar Edri3
1Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel. amitrit@clalit.org.il.
Objective:
Research on age and prognosis for oral cavity squamous cell carcinomas (OSCCs) has shown inconsistent results. We aimed to establish age as an independent prognostic factor and determine an age cutoff for staging in OSCC.
Methods:
Electronic records were reviewed for all OSCC patients treated between 2000 and 2020.
Results:
The study involved 250 patients, identifying a mortality cutoff age of 65 through Receiver Operating Characteristic curve analysis (sensitivity 77%, specificity 49%). Patients ≥ 65 had lower survival rates for early-stage (TNM I-II; 63.5% vs. 96%, p < 0.001) and advanced-stage (TNM III-IV; 37.5% vs. 62%, p = 0.011) diseases. A proposed age-based TNM staging system categorized ≥ 65 as Stage III/IV, with comparable survival rates confirmed in a revised analysis.
Conclusion:
The study identifies age, with a 65-year cutoff, as an independent prognostic factor in OSCC and highlights its role in improving current staging systems.
Level Of Evidence:
III.
