Prognostic value of a mandibular canal staging system for primary lesions in patients with lower gingival squamous cell carcinoma: a multicenter, retrospective study.

Gingival neoplasms Mandibular canal Neoplasm invasiveness Prognostic factor TNM classification

Journal

International journal of clinical oncology
ISSN: 1437-7772
Titre abrégé: Int J Clin Oncol
Pays: Japan
ID NLM: 9616295

Informations de publication

Date de publication:
02 May 2024
Historique:
received: 01 12 2023
accepted: 22 04 2024
medline: 2 5 2024
pubmed: 2 5 2024
entrez: 2 5 2024
Statut: aheadofprint

Résumé

The Union for International Cancer Control and American Joint Committee on Cancer tumor staging system is used globally for treatment planning. As it may be insufficient for tumor staging of lower gingival carcinomas, we proposed the mandibular canal tumor staging system. In this study, we aimed to compare the two systems for such tumor staging and to identify prognostic markers. This multicenter, retrospective study included patients with lower gingival squamous cell carcinoma who underwent radical surgery during 2001-2018. We compared survival rates (Kaplan-Meier estimator) and patient stratification according to the two systems. The proposed system yielded more balanced patient stratification than the existing system. Progression in the tumor grade according to the proposed system was associated with a poorer prognosis. The 5-year overall and disease-specific survival rates for the entire cohort were 74.9% and 81.8%, respectively. Independent factors affecting overall survival were tumor stage according to the proposed system, excision margins, and number of positive nodes, whereas those affecting disease-specific survival were excision margins and number of positive nodes. Subsite-specific tumor classification should be used for patients with oral cancer, and our results suggest that mandibular canal tumor classification may be effective for patients with lower gingival carcinoma.

Sections du résumé

BACKGROUND BACKGROUND
The Union for International Cancer Control and American Joint Committee on Cancer tumor staging system is used globally for treatment planning. As it may be insufficient for tumor staging of lower gingival carcinomas, we proposed the mandibular canal tumor staging system. In this study, we aimed to compare the two systems for such tumor staging and to identify prognostic markers.
METHODS METHODS
This multicenter, retrospective study included patients with lower gingival squamous cell carcinoma who underwent radical surgery during 2001-2018. We compared survival rates (Kaplan-Meier estimator) and patient stratification according to the two systems.
RESULTS RESULTS
The proposed system yielded more balanced patient stratification than the existing system. Progression in the tumor grade according to the proposed system was associated with a poorer prognosis. The 5-year overall and disease-specific survival rates for the entire cohort were 74.9% and 81.8%, respectively. Independent factors affecting overall survival were tumor stage according to the proposed system, excision margins, and number of positive nodes, whereas those affecting disease-specific survival were excision margins and number of positive nodes.
CONCLUSIONS CONCLUSIONS
Subsite-specific tumor classification should be used for patients with oral cancer, and our results suggest that mandibular canal tumor classification may be effective for patients with lower gingival carcinoma.

Identifiants

DOI: 10.1007/s10147-024-02542-y PMID: 38696052
pubmed: 38696052
doi: 10.1007/s10147-024-02542-y
pii: 10.1007/s10147-024-02542-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.

Références

Vilches LA (2020) Head and neck cancers: new etiological insights. In: Wild CP, Weiderpass E, Stewart BW (eds) World cancer report: Cancer research for cancer prevention. International Agency for Research on Cancer, Lyon, pp310–322
Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249
doi: 10.3322/caac.21660 pubmed: 33538338
Mehanna H, Paleri V, West CM et al (2011) Head and neck cancer-part 1: epidemiology, presentation, and preservation. Clin Otolaryngol 36:65–68
doi: 10.1111/j.1749-4486.2010.02231.x pubmed: 21414154
Ota Y, Noguchi T, Ariji E et al (2021) General rules for clinical and pathological studies on oral cancer (2nd edition): a synopsis. Int J Clin Oncol 26:623–635
doi: 10.1007/s10147-020-01812-9 pubmed: 33721113 pmcid: 7979619
Shingaki S, Nomura T, Takada M et al (2002) Squamous cell carcinomas of the mandibular alveolus: analysis of prognostic factors. Oncology 62:17–24
doi: 10.1159/000048242 pubmed: 11810039
Amin MB, Edge S, Greene F et al (2017) AJCC cancer staging manual, 8th edn. Springer, New York
Brierley JD, Gospodarowicz MK, Wittekind C (2017) TNM classification of malignant tumors, 8th edn. Willey Blackwell, Hoboken, NJ
Singhavi HR, Chakrabarti S, Singh A et al (2020) Comparison of the seventh and eighth editions American Joint Committee Cancer classification system in oral cavity squamous cell cancers. Int J Cancer 146:3379–3384
doi: 10.1002/ijc.32720 pubmed: 31583706
Vuity D, McMahon J, Takhiuddin S, et al (2018) Is the 8th edition of the Union for International Cancer Control staging of oral cancer good enough? Br J Oral Maxillofac Surg 56:272–277
Matos LL, Dedivitis RA, Kulcsar MAV, et al (2017) External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients. Oral Oncol 71:47–53
Fried D, Mullins B, Weissler M et al (2014) Prognostic significance of bone invasion for oral cavity squamous cell carcinoma considered T1/T2 by American Joint Committee on Cancer size criteria. Head Neck 36:776–781
doi: 10.1002/hed.23367 pubmed: 23616341
Fives C, Nae A, Roche P et al (2017) Impact of mandibular invasion on prognosis in oral squamous cell carcinoma four centimeters or less in size. Laryngoscope 127:849–854
doi: 10.1002/lary.26211 pubmed: 27481484
Cheng CS, Chang CM, Hsiao YL et al (2016) Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: a new classification. Head Neck 38:339–346
doi: 10.1002/hed.23896 pubmed: 25331819
Gomez D, Faucher A, Picot V et al (2000) Outcome of squamous cell carcinoma of the gingiva: a follow-up study of 83 cases. J Craniomaxillofac Surg 28:331–335
doi: 10.1054/jcms.2000.0177 pubmed: 11465139
Lubek J, El-Hakim M, Salama AR et al (2011) Gingival carcinoma: retrospective analysis of 72 patients and indications for elective neck dissection. Br J Oral Maxillofac Surg 49:182–185
doi: 10.1016/j.bjoms.2010.04.005 pubmed: 20462676
Okura M, Yanamoto S, Umeda M et al (2016) Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma. Cancer Med 5:3378–3385
doi: 10.1002/cam4.899 pubmed: 27758080 pmcid: 5224841
Tam S, Amit M, Zafereo M et al (2019) Depth of invasion as a predictor of nodal disease and survival in patients with oral tongue squamous cell carcinoma. Head Neck 41:177–184
doi: 10.1002/hed.25506 pubmed: 30537401
Rogers SN, Brown JS, Woolgar JA et al (2009) Survival following primary surgery for oral cancer. Oral Oncol 45:201–211
doi: 10.1016/j.oraloncology.2008.05.008 pubmed: 18674959
Mascitti M, Rubini C, De Michele F, et al (2018) American Joint Committee on Cancer staging system 7th edition versus 8th edition: any improvement for patients with squamous cell carcinoma of the tongue? Oral Surg Oral Med Oral Pathol Oral Radiol 126:415–423
Groome PA, Schulze KM, Mackillop WJ et al (2001) A comparison of published head and neck stage groupings in carcinomas of the tonsillar region. Cancer 92:1484–1494
doi: 10.1002/1097-0142(20010915)92:6<1484::AID-CNCR1473>3.0.CO;2-W pubmed: 11745226
Bernier J, Cooper JS, Pajak TF et al (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (# 22931) and RTOG (# 9501). Head Neck 27:843–850
doi: 10.1002/hed.20279 pubmed: 16161069
Ebrahimi A, Murali R, Gao K et al (2011) The prognostic and staging implications of bone invasion in oral squamous cell carcinoma. Cancer 117:4460–4467
doi: 10.1002/cncr.26032 pubmed: 21437887
Yanamoto S, Otsuru M, Ota Y et al (2015) Multicenter retrospective study of adjuvant therapy for patients with pathologically lymph node-positive oral squamous cell carcinoma: analysis of covariance using propensity score. Ann Surg Oncol 22(Suppl 3):S992–S999
doi: 10.1245/s10434-015-4824-5 pubmed: 26289809
Okura M, Hiranuma T, Adachi T et al (1998) Induction chemotherapy is associated with an increase in the incidence of locoregional recurrence in patients with carcinoma of the oral cavity: results from a single institution. Cancer 82:804–815
doi: 10.1002/(SICI)1097-0142(19980301)82:5<804::AID-CNCR2>3.0.CO;2-J pubmed: 9486567
Niu LX, Feng ZE, Wang DC et al (2017) Prognostic factors in mandibular gingival squamous cell carcinoma: a 10-year retrospective study. Int J Oral Maxillofac Surg 46:137–143
doi: 10.1016/j.ijom.2016.09.014 pubmed: 28029423
Myers JN, Greenberg JS, Mo V et al (2001) Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue. Cancer 92:3030–3036
doi: 10.1002/1097-0142(20011215)92:12<3030::AID-CNCR10148>3.0.CO;2-P pubmed: 11753980
Woolgar JA, Rogers SN, Lowe D et al (2003) Cervical lymph node metastasis in oral cancer: the importance of even microscopic extracapsular spread. Oral Oncol 39:130–137
doi: 10.1016/S1368-8375(02)00030-1 pubmed: 12509965
Bernier J, Domenge C, Ozsahin M et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952
doi: 10.1056/NEJMoa032641 pubmed: 15128894
Cooper JS, Pajak TF, Forastiere AA et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944
doi: 10.1056/NEJMoa032646 pubmed: 15128893
Harari PM, Harris J, Kies MS et al (2014) Postoperative chemoradiotherapy and cetuximab for high-risk squamous cell carcinoma of the head and neck: Radiation Therapy Oncology Group RTOG-0234. J Clin Oncol 32:2486–2495
doi: 10.1200/JCO.2013.53.9163 pubmed: 25002723 pmcid: 4121506

Auteurs

Nobuhiro Yamakawa (N)

Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan. yamanobu@naramed-u.ac.jp.
ORCID: 0000-0002-9061-1301

Masaya Okura (M)

Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 1-15-6 Asahi-Cho, Matsusaka, Mie, 515-8557, Japan.

Takumi Hasegawa (T)

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.

Mitsunobu Otsuru (M)

Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.

Hironori Sakai (H)

Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

Eiji Hirai (E)

Oral and Maxillofacial Surgery, Oita Red Cross Hospital, 3-2-37 Chiyomachi, Oita, 870-0033, Japan.

Shin Rin (S)

Department of Clinical Oral Oncology, National Hospital Organisation Hokkaido Cancer Center, 3-54 Kikusui 4-2, Shiroisi-Ku, Sapporo, Hokkaido, 003-0804, Japan.

Shin-Ichi Yamada (SI)

Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.

Souichi Yanamoto (S)

Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima, 734-8553, Japan.

Yusuke Yokota (Y)

Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Masahiro Umeda (M)

Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.

Hiroshi Kurita (H)

Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

Michihiro Ueda (M)

Department of Clinical Oral Oncology, National Hospital Organisation Hokkaido Cancer Center, 3-54 Kikusui 4-2, Shiroisi-Ku, Sapporo, Hokkaido, 003-0804, Japan.

Masaya Akashi (M)

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.

Tadaaki Kirita (T)

Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.

Classifications MeSH