Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system

Ardalan Ebrahimi; Ziv Gil; Moran Amit; Tzu Chen Yen; Chun Ta Liao; Pankaj Chatturvedi; Jaiprakash Agarwal; Luiz Kowalski; Matthias Kreppel; Claudio Cernea; Jose Brandao; Gideon Bachar; Andrea Bolzoni Villaret; Dan Fliss; Eran Fridman; K. Thomas Robbins; Jatin Shah; Snehal Patel; Jonathan Clark

doi:10.1002/hed.23871

Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system

Ardalan Ebrahimi^*, Ziv Gil, Moran Amit, Tzu Chen Yen, Chun Ta Liao, Pankaj Chatturvedi, Jaiprakash Agarwal, Luiz Kowalski, Matthias Kreppel, Claudio Cernea, Jose Brandao, Gideon Bachar, Andrea Bolzoni Villaret, Dan Fliss, Eran Fridman, K. Thomas Robbins, Jatin Shah, Snehal Patel, Jonathan Clark

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

Background We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. Methods An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. Results Univariate analysis revealed no difference in locoregional failure (p =.184), DSS (p =.761), or OS (p =.475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. Conclusion The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.

Original language	English
Pages (from-to)	135-139
Number of pages	5
Journal	Head and Neck
Volume	38
Issue number	1
DOIs	https://doi.org/10.1002/hed.23871
Publication status	Published - 1 Jan 2016
Externally published	Yes

Keywords

cancer staging
head and neck neoplasms
lymph node metastases
oral squamous cell carcinoma
prognosis

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Ebrahimi, A., Gil, Z., Amit, M., Yen, T. C., Liao, C. T., Chatturvedi, P., Agarwal, J., Kowalski, L., Kreppel, M., Cernea, C., Brandao, J., Bachar, G., Villaret, A. B., Fliss, D., Fridman, E., Robbins, K. T., Shah, J., Patel, S., & Clark, J. (2016). Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system. Head and Neck, 38(1), 135-139. https://doi.org/10.1002/hed.23871

@article{d91a3130e62f486fb970911d8ac63323,

title = "Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system",

abstract = "Background We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. Methods An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. Results Univariate analysis revealed no difference in locoregional failure (p =.184), DSS (p =.761), or OS (p =.475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. Conclusion The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.",

keywords = "cancer staging, head and neck neoplasms, lymph node metastases, oral squamous cell carcinoma, prognosis",

author = "Ardalan Ebrahimi and Ziv Gil and Moran Amit and Yen, {Tzu Chen} and Liao, {Chun Ta} and Pankaj Chatturvedi and Jaiprakash Agarwal and Luiz Kowalski and Matthias Kreppel and Claudio Cernea and Jose Brandao and Gideon Bachar and Villaret, {Andrea Bolzoni} and Dan Fliss and Eran Fridman and Robbins, {K. Thomas} and Jatin Shah and Snehal Patel and Jonathan Clark",

year = "2016",

month = jan,

day = "1",

doi = "10.1002/hed.23871",

language = "English",

volume = "38",

pages = "135--139",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley & Sons",

number = "1",

}

Ebrahimi, A, Gil, Z, Amit, M, Yen, TC, Liao, CT, Chatturvedi, P, Agarwal, J, Kowalski, L, Kreppel, M, Cernea, C, Brandao, J, Bachar, G, Villaret, AB, Fliss, D, Fridman, E, Robbins, KT, Shah, J, Patel, S & Clark, J 2016, 'Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system', Head and Neck, vol. 38, no. 1, pp. 135-139. https://doi.org/10.1002/hed.23871

Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system. / Ebrahimi, Ardalan; Gil, Ziv; Amit, Moran et al.
In: Head and Neck, Vol. 38, No. 1, 01.01.2016, p. 135-139.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer

T2 - time to acknowledge an arbitrary distinction and modify the system

AU - Ebrahimi, Ardalan

AU - Gil, Ziv

AU - Amit, Moran

AU - Yen, Tzu Chen

AU - Liao, Chun Ta

AU - Chatturvedi, Pankaj

AU - Agarwal, Jaiprakash

AU - Kowalski, Luiz

AU - Kreppel, Matthias

AU - Cernea, Claudio

AU - Brandao, Jose

AU - Bachar, Gideon

AU - Villaret, Andrea Bolzoni

AU - Fliss, Dan

AU - Fridman, Eran

AU - Robbins, K. Thomas

AU - Shah, Jatin

AU - Patel, Snehal

AU - Clark, Jonathan

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. Methods An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. Results Univariate analysis revealed no difference in locoregional failure (p =.184), DSS (p =.761), or OS (p =.475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. Conclusion The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.

AB - Background We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. Methods An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. Results Univariate analysis revealed no difference in locoregional failure (p =.184), DSS (p =.761), or OS (p =.475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. Conclusion The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment.

KW - cancer staging

KW - head and neck neoplasms

KW - lymph node metastases

KW - oral squamous cell carcinoma

KW - prognosis

UR - http://www.scopus.com/inward/record.url?scp=84955643895&partnerID=8YFLogxK

U2 - 10.1002/hed.23871

DO - 10.1002/hed.23871

M3 - Article

C2 - 25227311

AN - SCOPUS:84955643895

SN - 1043-3074

VL - 38

SP - 135

EP - 139

JO - Head and Neck

JF - Head and Neck

IS - 1

ER -

Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: time to acknowledge an arbitrary distinction and modify the system

Abstract

Keywords

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