Sano D, Yabuki K, Arai Y, Tanabe T, Chiba Y, Nishimura G, Takahashi H, Yamanaka S, Oridate N. The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan
Sano D, Yabuki K, Arai Y, Tanabe T, Chiba Y, Nishimura G, Takahashi H, Yamanaka S, Oridate N. The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan
复制标题
Sano D，Yabuki K，Arai Y，Tanabe T，Chiba Y，Nishimura G，Takahashi H，Yamanaka S，Oridate N。第 8 版 AJCC/UICC TNM 中人乳头瘤病毒相关口咽癌新 TNM 分类的适用性
DOI：
10.1016/j.anl.2017.07.010
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发表时间：
2018
影响因子：
1.7
通讯作者：
Oridate N
中科院分区：
文献类型：
--
作者：
Sano D;Yabuki K;Arai Y;Tanabe T;Chiba Y;Nishimura G;Takahashi H;Yamanaka S;Oridate N
本研究的目的是验证美国癌症联合委员会（AJCC）/国际癌症控制联盟（UICC）第8版TNM分期系统中人乳头瘤病毒（HPV）相关口咽癌（OPC）的新TNM分类在日本的适用性。本研究回顾性分析了2001年11月至2015年7月期间的基础治疗。结果40例（44.0%）OPC患者HPV阳性，其中10例（44.0%）HPV阳性。从AJCC/UICC TNM分类第7版到第8版，HPV阳性OPC患者的疾病分期分布发生了显著变化。然而，无论是第8版还是第7版AJCC/UICC TNM分期系统都不能充分预测我们患者系列中HPV阳性OPC患者的结局。另一方面，我们的多变量分析表明，淋巴结缠结和年龄≥63岁是无进展生存期的独立预后因素。此外，在AJCC/UICC第8版TNM分期系统中，HPV阳性OPC患者中，无淋巴结缠结的I期患者的总体生存率和无进展生存率显著高于有淋巴结缠结的I期患者以及II期和III期患者（P= 0.008，P = 0.043，分别）。结论我们的结果表明，HPV阳性OPC患者的缠结淋巴结可能需要额外检查，以应用AJCC/第8版UICC TNM分类更充分地预测HPV阳性OPC患者的结局。
ObjectiveThe purpose of this study is to validate the applicability of new TNM classification for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) in the 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system in Japan.MethodsA total of 91 OPC patients treated with radiation-based therapy between November 2001 and July 2015 were analyzed retrospectively in this study. HPV infection status was evaluated using tumor p16 expression.Results40 OPC patients (44.0%) had HPV-positive disease in this study. The distribution of disease stage of HPV-positive OPC patients dramatically changed from the 7th edition to the 8th edition of AJCC/UICC TNM classification. However, neither the 8th edition nor the 7th edition of the AJCC/UICC TNM staging system could adequately predict outcomes of HPV-positive OPC patients in our patient series. On the other hand, our multivariate analysis indicated that matted nodes and age ≥63 were independent prognostic factors for progression-free survival. In addition, HPV-positive OPC patients with stage I without matted nodes showed significantly better overall and progression-free survival compared with those with stage I with matted nodes and stages II and III in the 8th edition of the AJCC/UICC TNM staging system (P= 0.008, andP= 0.043, respectively).ConclusionOur results suggested that matted nodes of HPV-positive OPC patients might be additionally examined to apply the 8th edition of AJCC/UICC TNM classification for more adequate predicting outcomes of HPV-positive OPC patients.