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Staging of supraglottic cancer
Archives of Otolaryngology (Chicago, Ill. : 1960)
|November 1, 1982
Summary
The 1977 American Joint Committee staging system for supraglottic laryngeal cancer introduced changes impacting prognosis. However, reclassifying T4 NO cancers from stage III to IV appears unjustified and should be reverted.
Area of Science:
- Oncology
- Otorhinolaryngology
- Cancer Staging
Background:
- The American Joint Committee for Cancer Staging and End-Results Reporting (AJC) revised the laryngeal cancer staging system in 1977.
- Previous staging (1972) and the revised system (1977) utilized the TNM classification for supraglottic laryngeal cancer.
Purpose of the Study:
- To evaluate the prognostic impact of the 1977 AJC staging system revisions for supraglottic laryngeal cancer.
- To correlate patient outcomes with staging classifications under both the 1972 and 1977 AJC systems.
Main Methods:
- Retrospective review of 178 supraglottic laryngeal cancer cases treated between 1955 and 1976.
- Classification of each case using both the 1972 and 1977 AJC TNM staging systems.
Main Results:
- The 1977 AJC staging system resulted in significant shifts in patient stage distribution compared to the 1972 system.
- Specifically, the upstaging of T4 NO supraglottic cancers from stage III to stage IV under the 1977 system was observed.
- The study found six specific changes in the TNM classification to be justified, but questioned the upstaging of T4 NO cancers.
Conclusions:
- Most revisions in the 1977 AJC staging system for supraglottic laryngeal cancer appear justified based on prognostic correlation.
- The upstaging of T4 NO supraglottic cancers from stage III to stage IV is deemed unjustified and should be reconsidered.