Validation of the pathological classification of lymph node metastasis for head and neck tumors according to the 8th edition of the TNM Classification of Malignant Tumors
Validation of the pathological classification of lymph node metastasis for head and neck tumors according to the 8th edition of the TNM Classification of Malignant Tumors
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DOI：
10.1016/j.oraloncology.2017.05.003
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发表时间：
2017-07-01
期刊：
影响因子：
4.8
通讯作者：
Leon, Xavier
中科院分区：
文献类型：
--
作者：
Garcia, Jacinto;Lopez, Montserrat;Leon, Xavier
目的：第 8 版头颈肿瘤 TNM 分类的主要变化之一是将囊外扩散 (ECS) 作为评估临床 (cN) 和病理 (pN) 区域扩展的标准。我们研究的目的是评估将 ECS 纳入第 8 版 TNM 分类建立的头颈鳞状细胞癌 (HNSCC) 患者接受颈清扫术治疗的病理分类中所得出的预后能力。 材料和方法：对 1990 年至 2013 年间 1188 例接受颈清扫术治疗的 HNSCC 患者进行回顾性研究。 50.1% 的颈清扫术。病理记录显示 50.5% 的阳性颈清扫术中有 ECS。第8版TNM分类变更的实施导致第7版TNM分类中20.9%的pN1患者升期至pN2a，第7版TNM分类中58.4%的pN2患者升期至pN3b。我们对两种分类的质量进行了客观比较。与第七版TNM分类相比，第八版TNM分类在pN类别之间的病因特异性生存区分和类别之间的病例数分布方面均取得了更好的结果。结论：将ECS纳入颈部淋巴结的病理分类（pN）提高了第八版TNM分类的预后能力。 (C) 2017 Elsevier Ltd. 保留所有权利。
Objectives: One of the main changes in the 8th edition of the TNM Classification for head and neck tumors is the inclusion of extracapsular spread (ECS) as a criterion for evaluating the regional extension, both clinical (cN) and pathological (pN). The objective of our study is to evaluate the prognostic capacity derived from the inclusion of the ECS in the pathological classification of head and neck squamous cell carcinoma (HNSCC) patients treated with a neck dissection, as established by the 8th edition TNM Classification.Materials and methods: Retrospective study of 1188 patients with HNSCC treated with a neck dissection between1990 and 2013.Results: There were lymph node metastasis in 50.1% of the neck dissections. The pathological record revealed ECS in 50.5% of the positive neck dissections. The implementation of the changes of the 8th edition TNM classification produced the upstaging of 20.9% of the patients classified as pN1 with the 7th edition TNM classification to pN2a, and the upstaging of 58.4% of the patients classified as pN2 with the 7th edition TNM classification to pN3b. We conducted an objective comparison of the quality of both classifications. The 8th TNM classification edition achieved better results regarding both the discrimination in cause-specific survival between pN categories and in the distribution in the number of cases between categories than the 7th edition TNM classification.Conclusion: The inclusion of ECS in the pathological classification (pN) of the neck nodes improves the prognostic capacity of the 8th TNM Classification edition. (C) 2017 Elsevier Ltd. All rights reserved.