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Oral Oncol. 2017 Nov;74:30-33. doi: 10.1016/j.oraloncology.2017.09.007. Epub 2017 Sep 19.

Tumor thickness versus depth of invasion - Analysis of the 8th edition American Joint Committee on Cancer Staging for oral cancer.

Author information

1
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia. Electronic address: dirvenrichard@hotmail.com.
2
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Department of Head & Neck Surgery, Liverpool Hospital, Sydney, Australia; Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Sydney, Australia.
3
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.
4
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia.
5
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
6
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia; South West Clinical School, University of New South Wales, Sydney, Australia.

Abstract

OBJECTIVES:

The primary aim of this study is to compare the effect of using tumor thickness versus depth of invasion (DOI) to determine the 8th edition AJCC T-category on survival in a large cohort of OSCC.

MATERIALS AND METHODS:

A retrospective cohort study of patients whose clinicopathologic information had been collected prospectively into a dedicated head and neck database. 927 patients with oral SCC were identified in this cohort, with the final study population including 456 patients with complete information on DOI, tumor thickness, T and N staging and follow-up.

RESULTS:

26 (5.7%) patients had a different AJCC 8 T category when using thickness instead of depth. 15 were upstaged from T1 to T2, 10 upstaged from T2 to T3 and 1 down staged from T2 to T1. Additionally, similar stratification of disease-specific and overall survival curves were found for T category based on DOI and thickness.

CONCLUSION:

The T category and TNM stage prognostic performance of 8th edition AJCC staging of oral cancer is similar regardless of whether DOI or thickness is used as the T-category modifier. In centers without complete DOI data it is reasonable to impute thickness for retrospective survival analyses using the 8th edition of the AJCC staging system.

KEYWORDS:

AJCC 8; Depth of invasion (DOI); Disease-specific survival; Oral SCC; Overall survival; Staging; T category; Thickness

[Indexed for MEDLINE]

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