Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
| Autor: | Xiaosong Mu, Wendu Pang, Wei Xu, Jianqing Qiu, Qiurui Liu, Ke Qiu, Yufang Rao, Jianjun Ren, Junhong Li, Yijun Dong, Wei Zhang, Yu Zhao, Danni Cheng, Minzi Mao |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty Multivariate analysis Stell’s classification Metastasis Internal medicine Cox proportional hazards regression Humans Medicine Radiology Nuclear Medicine and imaging Middle Ear Squamous Cell Carcinoma staging scheme Ear Neoplasms Research Articles RC254-282 Aged Neoplasm Staging Cancer staging TNM Classifications business.industry Hazard ratio middle ear squamous cell carcinoma Clinical Cancer Research Neoplasms. Tumors. Oncology. Including cancer and carcinogens Middle Aged Prognosis Explained variation medicine.disease SEER Carcinoma Squamous Cell Female business prognoses Research Article |
| Zdroj: | Cancer Medicine, Vol 10, Iss 22, Pp 7958-7967 (2021) Cancer Medicine |
| ISSN: | 2045-7634 |
| Popis: | Background A universally acknowledged cancer staging system considering all aspects of the T‐, N‐, and M‐classifications for middle ear squamous cell carcinoma (MESCC) remains absent, limiting the clinical management of MESCC patients. Materials and Methods A total of 214 MESCC patients were extracted from the SEER (the Surveillance, Epidemiology, and End Results) database between 1973 and 2016. The relationships between patient’s characteristics and prognoses were analyzed by Kaplan–Meier and Cox proportional hazards regression models. Novel staging schemes for MESCC were designed by adjusted hazard ratio (AHR) modeling method according to the combinations of Stell’s T‐classification and the eighth AJCC N‐ and M‐classifications, of which performances were evaluated based on five criteria: hazard consistency, hazard discrimination, explained variation, likelihood difference, and balance. Results T‐classification was the most significant prognostic factor for MESCC patients in multivariable analysis (p = 0.021). The N‐ and M‐classifications also had obvious prognostic effect but were not statistically significant by multivariate analysis due to the limited metastasis events. Three novel staging schemes (AHR‐Ⅰ–Ⅲ models, different combination of T‐ and N‐classifications) and ST (solely derived from Stell’s T‐classification) were developed, among which the AHR‐Ⅰ staging scheme performed best. Conclusions Tumor extension, quantified by Stell’s T‐classification, is the most significant prognostic factor for MESCC patients. However, our AHR‐Ⅰ staging scheme, a comprehensive staging scheme that integrating T‐, N‐, and M‐classifications, might be an optimal option for clinical practitioners to predict MESCC patients’ prognosis and make proper clinical decisions. All of Stell’s T‐classification, N‐ and M‐classifications of the eighth AJCC staging system for head and neck cancer showed obvious prognostic effects in middle ear squamous cell carcinoma (MESCC) patients. Stell’s T‐classification is the most significant as well as an independent prognostic factor for MESCC patients. Our newly developed AHR‐Ⅰ staging scheme displayed better performance than the Stell’s T‐classification in almost all existing criterion, which stresses the importance of a comprehensive staging scheme integrating T‐, N‐, and M‐classifications for MESCC and provides a new perspective for clinical practitioner who solely rely on tumor extension for making clinical decisions. |
| Databáze: | OpenAIRE |
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