Discrepancy between cTNM and pTNM staging of oral cavity cancers and its prognostic significance
Nayeon Choi MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorYangseop Noh MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorEun Kyu Lee MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorManki Chung MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorChung-Hwan Baek MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorCorresponding Author
Kwan-Hyuck Baek PhD
Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Correspondence
Han-Sin Jeong, MD, PhD, Department of Otorhinolaryngology—Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Email: [email protected]
Kwan-Hyuck Baek, PhD, Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Email: [email protected]
Search for more papers by this authorCorresponding Author
Han-Sin Jeong MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Correspondence
Han-Sin Jeong, MD, PhD, Department of Otorhinolaryngology—Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Email: [email protected]
Kwan-Hyuck Baek, PhD, Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Email: [email protected]
Search for more papers by this authorNayeon Choi MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorYangseop Noh MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorEun Kyu Lee MD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorManki Chung MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorChung-Hwan Baek MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Search for more papers by this authorCorresponding Author
Kwan-Hyuck Baek PhD
Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Correspondence
Han-Sin Jeong, MD, PhD, Department of Otorhinolaryngology—Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Email: [email protected]
Kwan-Hyuck Baek, PhD, Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Email: [email protected]
Search for more papers by this authorCorresponding Author
Han-Sin Jeong MD, PhD
Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Correspondence
Han-Sin Jeong, MD, PhD, Department of Otorhinolaryngology—Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Email: [email protected]
Kwan-Hyuck Baek, PhD, Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Email: [email protected]
Search for more papers by this authorAbstract
Introduction
Accurate tumor-node-metastasis(TNM) staging of oral cavity cancer(OCC) is very important in the management of this dismal disease. However, stage migration from cTNM to pTNM was found in a portion of OCC patients. The objective of this study was to determine the possible causes of discrepancy between cTNM and pTNM in OCC and the clinical impacts of stage migration.
Methods
Clinical and pathological data of 252 OCC patients were retrospectively reviewed and compared each other. Clinical staging was determined through the multidisciplinary evaluation of pre-treatment work-ups including PET/CT. In addition, we compared the up-staged cases with those in the no-change group with the same pTNM stages to identify the clinical impacts of such change.
Results
Clinical staging yielded overall 82.5% diagnostic accuracy in predicting pathological tumor status, and tumor extent was under-estimated in 9.5-13.5% of cases. The main causes of T up-staging were under-estimation of surface dimension (62.5%) and deep invasion to tongue extrinsic muscles (37.5%). N up-staging was due to occult single (57.6%) and multiple (42.4%) metastases. Surprisingly, TNM up-staging in our series did not have prognostic significance under the current management protocol.
Conclusion
Clinical under-estimation of pathological tumor extent occurred in approximately 13% of OCC, without clinical impacts on prognosis.
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