Clinical study on the prognostic and risk stratification effect of the 8th revised TNM staging on patients with early oral squamous cell carcinoma

doi:10.19438/j.cjoms.2022.06.009

Abstract

Abstract: PURPOSE: To understand the effect of the 8th revised TNM staging on the risk stratification and prognosis of early oral mucosal squamous cell carcinoma (OSCC). METHODS: One hundred and four patients with early OSCC who underwent surgery in our hospital from November 2008 to December 2016 were reviewed, and the effect of stage migration caused by the revised version of TNM stage 8 on the risk stratification and prognosis of patients was analyzed. SPSS 23.0 software package was used for data analysis. RESULTS: The depth of tumor invasion in patients with early OSCC was significantly correlated with the prognosis. Thirty-nine of 70 patients with pT1 in the 7th edition were upgraded to pT2 in the 8th edition. There was significant difference in postoperative recurrence between upgraded and non-upgraded patients (P<; 0.001), but there was no significant difference in cervical lymph node metastasis(P=0.1169). Seventeen of the 34 patients with pT2 in the 7th edition were upgraded to pT3 in the 8th edition. There was no significant difference in postoperative recurrence and cervical lymph node metastasis between upgraded and non-upgraded patients(P>; 0.05). There was significant difference in the overall survival rate among the stages of the 7th edition (P=0.046), but there was no significant difference in the disease-specific survival rate (P=0.242). There were significant differences in the overall survival rate (P<; 0.001) and disease-specific survival rate (P<; 0.001) among the stages of the 8th edition. CONCLUSIONS: The increase of tumor invasion depth indicates the deterioration of clinical prognosis in patients with early OSCC. Compared with the 7th edition, the 8th edition of TNM staging revision has better prognosis and risk stratification ability for patients with early OSCC. For patients with pT2 or above, more extensive surgical treatment including simultaneous selective neck dissection should be performed. Postoperative adjuvant treatment can improve the survival rate of patients.

Key words: Oral cancer, Squamous cell carcinoma, Depth of invasion, Extranodal extension, TNM stage

CLC Number:

R739.8

ZHOU Yu, WENG Hai-yan, SI Cheng-yun, DUAN Xian-jie, AN Xing-fei, ZHANG Li-yu. Clinical study on the prognostic and risk stratification effect of the 8th revised TNM staging on patients with early oral squamous cell carcinoma[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(6): 571-576.

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