Tumour classification for early oral cancer: re-evaluate the current TNM classification

Tsu-Hui (Hubert) Low; Kan Gao; Michael Elliott; Jonathan R. Clark

doi:10.1002/hed.23581

Tumour classification for early oral cancer: re-evaluate the current TNM classification

Tsu-Hui (Hubert) Low, Kan Gao, Michael Elliott, Jonathan R. Clark

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

35 Citations (Scopus)

Abstract

Background: We hypothesized that incorporation of tumor thickness into the tumor–node–metastasis (TNM) system will provide better prognostic information. Tumors were reclassified as T1 if ≤5‐mm thick/≤4‐cm diameter, and T2 if >5‐mm thick/≤4‐cm diameter. Methods: A retrospective analysis was conducted of 322 patients with T1 and T2 oral squamous cell carcinoma (SCC) between 1987 and 2012. Univariable survival analysis was performed using the log‐rank test and multivariable analysis using the Cox proportional hazards model. Results: Multivariable analysis confirmed that tumor thickness is the most important predictor of disease‐specific survival (DSS; hazard ratio [HR], 2.7; p = .03) and overall survival (OS; HR, 2.9; p = .001). Using the current TNM classification system, there is no significant difference in survival between the T1 and T2 groups for DSS (p = .13) or OS (p = .66). The revised staging system was superior at stratifying patients according to the T classification for both DSS (p = .016) and OS (p < .001). Conclusion: Tumor thickness is an important prognostic indicator in early oral SCC and should be incorporated in the TNM classification system.

Original language	English
Pages (from-to)	223-228
Number of pages	6
Journal	Head and Neck
Volume	37
Issue number	2
DOIs	https://doi.org/10.1002/hed.23581
Publication status	Published - Feb 2015
Externally published	Yes

Keywords

oral cavity/mouth neoplasm
head and neck cancer
tumor thickness
depth of invasion
staging

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title = "Tumour classification for early oral cancer: re-evaluate the current TNM classification",

abstract = "Background: We hypothesized that incorporation of tumor thickness into the tumor–node–metastasis (TNM) system will provide better prognostic information. Tumors were reclassified as T1 if ≤5‐mm thick/≤4‐cm diameter, and T2 if >5‐mm thick/≤4‐cm diameter. Methods: A retrospective analysis was conducted of 322 patients with T1 and T2 oral squamous cell carcinoma (SCC) between 1987 and 2012. Univariable survival analysis was performed using the log‐rank test and multivariable analysis using the Cox proportional hazards model. Results: Multivariable analysis confirmed that tumor thickness is the most important predictor of disease‐specific survival (DSS; hazard ratio [HR], 2.7; p = .03) and overall survival (OS; HR, 2.9; p = .001). Using the current TNM classification system, there is no significant difference in survival between the T1 and T2 groups for DSS (p = .13) or OS (p = .66). The revised staging system was superior at stratifying patients according to the T classification for both DSS (p = .016) and OS (p < .001). Conclusion: Tumor thickness is an important prognostic indicator in early oral SCC and should be incorporated in the TNM classification system.",

keywords = "oral cavity/mouth neoplasm, head and neck cancer, tumor thickness, depth of invasion, staging",

author = "Low, {Tsu-Hui (Hubert)} and Kan Gao and Michael Elliott and Clark, {Jonathan R.}",

year = "2015",

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doi = "10.1002/hed.23581",

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pages = "223--228",

journal = "Head and Neck",

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T1 - Tumour classification for early oral cancer

T2 - re-evaluate the current TNM classification

AU - Low, Tsu-Hui (Hubert)

AU - Gao, Kan

AU - Elliott, Michael

AU - Clark, Jonathan R.

PY - 2015/2

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N2 - Background: We hypothesized that incorporation of tumor thickness into the tumor–node–metastasis (TNM) system will provide better prognostic information. Tumors were reclassified as T1 if ≤5‐mm thick/≤4‐cm diameter, and T2 if >5‐mm thick/≤4‐cm diameter. Methods: A retrospective analysis was conducted of 322 patients with T1 and T2 oral squamous cell carcinoma (SCC) between 1987 and 2012. Univariable survival analysis was performed using the log‐rank test and multivariable analysis using the Cox proportional hazards model. Results: Multivariable analysis confirmed that tumor thickness is the most important predictor of disease‐specific survival (DSS; hazard ratio [HR], 2.7; p = .03) and overall survival (OS; HR, 2.9; p = .001). Using the current TNM classification system, there is no significant difference in survival between the T1 and T2 groups for DSS (p = .13) or OS (p = .66). The revised staging system was superior at stratifying patients according to the T classification for both DSS (p = .016) and OS (p < .001). Conclusion: Tumor thickness is an important prognostic indicator in early oral SCC and should be incorporated in the TNM classification system.

AB - Background: We hypothesized that incorporation of tumor thickness into the tumor–node–metastasis (TNM) system will provide better prognostic information. Tumors were reclassified as T1 if ≤5‐mm thick/≤4‐cm diameter, and T2 if >5‐mm thick/≤4‐cm diameter. Methods: A retrospective analysis was conducted of 322 patients with T1 and T2 oral squamous cell carcinoma (SCC) between 1987 and 2012. Univariable survival analysis was performed using the log‐rank test and multivariable analysis using the Cox proportional hazards model. Results: Multivariable analysis confirmed that tumor thickness is the most important predictor of disease‐specific survival (DSS; hazard ratio [HR], 2.7; p = .03) and overall survival (OS; HR, 2.9; p = .001). Using the current TNM classification system, there is no significant difference in survival between the T1 and T2 groups for DSS (p = .13) or OS (p = .66). The revised staging system was superior at stratifying patients according to the T classification for both DSS (p = .016) and OS (p < .001). Conclusion: Tumor thickness is an important prognostic indicator in early oral SCC and should be incorporated in the TNM classification system.

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Tumour classification for early oral cancer: re-evaluate the current TNM classification

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