journal article·2023-10

Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Perineural Invasion: An International Multicenter Study

Shorook Na'ara, Narayana Subramaniam, Alberto Deganello, Shadi Shinnawi, Salem Billan, Davide Mattavelli, Marco Ferrari, Deepak Balasubramanian, Krishnakumar Thankappan, Subramania Iyer, Ziv Gil

Advanced Biology· Volume 7· Issue 10
Publisher page

Abstract

Abstract The objective of this study is to determine if the incorporation of perineural invasion (PNI) into the T‐classification would improve the prognostic performance of TNM‐8. An international, multicenter study of 1049 patients with oral cavity squamous cell carcinoma that were treated from 1994 to 2018 is performed. Various classification models are developed within each T‐category and evaluated using the Harrel‐concordance index (C‐index), Akaike‐information criterion (AIC), and visual inspection. Stratification into distinct prognostic categories, with internal validation, is performed using bootstrapping analysis (SPSS and R‐software). Through multivariate analysis, PNI is significantly associated with disease‐specific survival (p < 0.001). PNI integration into the staging system results in a significantly improved model compared with the current T category alone (lower AIC, p < 0.001). The PNI‐integrated model is superior in predicting differential outcomes between T3 and T4 patients. A new model for T‐classification of oral cavity squamous cell carcinoma is proposed, which is based on incorporating PNI into the staging system. These data can be used for future evaluations of the TNM staging system.
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Research context

OpenAlex topics: Head and Neck Cancer Studies · Oral Health Pathology and Treatment · Salivary Gland Tumors Diagnosis and Treatment

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Otolaryngology‐Head and Neck Surgery University of California‐San Francisco Helen Diller Family Comprehensive Cancer Center San Francisco CA 94158 USA

Department of Otolaryngology Head and Neck Surgery The Head and Neck Center Rambam Healthcare Campus Rappaport School of Medicine Technion – Israel Institute of Technology Haifa 3109601 Israel

Department of Head and Neck Oncology Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeetham Kochi 682041 India

Otolaryngology Head and Neck Surgery Department of IRCCS National Cancer Institute (INT) Milan 20133 Italy

Department of Oncology and Hematology‐Oncology University of Milan Milan Italy

Oncology Department The Head and Neck Center Rambam Healthcare Campus Haifa 3109601 Israel

Unit of Otorhinolaryngology‐Head and Neck Surgery Department of Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia 25123 Italy

Head and Neck Center Holy Family Hospital Nazareth 1641100 Israel

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