针对p16+口腔膜状细胞癌的更新分期系统的影响:是否遗漏了有价值的预后信息?
Kim Vo1, Colton Ladbury2, Andrew Tam2
1Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, California, USA.
Head & neck
|June 22, 2023
概括
更新的AJCC第八版p16+口腔状细胞癌 (OPSCC) 的分期失去了预后价值. 淋巴结数量,大小和囊外延伸 (ECE) 等关键因素显著影响生存.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 癌症的分期 癌症的分期
背景情况:
- 口腔状细胞癌 (OPSCC) 的分期对于治疗计划和预后至关重要.
- 美国癌症联合委员会 (AJCC) 第8版推出了更新的p16+ OPSCC节点分期.
- 有关简化AJCC第八版p16+ OPSCC节点分期系统的预后准确性存在担忧.
研究的目的:
- 根据AJCC第八版分期,评估p16+ OPSCC中节点特征的预后意义.
- 确定AJCC第八版节点分期系统是否保留了对p16+ OPSCC的预后值.
- 评估淋巴结数量,大小,横向性和外延伸 (ECE) 对整体存活率 (OS) 的影响.
主要方法:
- 利用国家癌症数据库 (NCDB) 来识别具有节点阳性p16+ OPSCC的患者.
- 分析了特定节点特征的预后影响,包括大小,数量,横向性和ECE.
- 在临床和病理队列中,评估的整体存活率 (OS) 是主要终点.
主要成果:
- 在临床队列中,增加的淋巴结阳性 (>1),ECE的存在,以及更大的结节大小 (>6厘米) 与明显较差的5年生存率有关.
- 在病态队列中,超过四个阳性淋巴结,ECE,最大结节大小>6厘米与明显较低的5年生存寿命相关.
- 统计分析 (p < 0.001) 证实了这些节点因子对患者存活率的显著影响.
结论:
- 在AJCC第8版p16+OPSCC节点分期中的简化导致了预后信息的丢失.
- 诸如数量,大小和ECE等节点特征仍然是p16+ OPSCC的关键预后指标.
- 可能需要重新评估节点分期系统,以恢复其预后准确性.
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