TNM staging compared with a new clinicopathological model in predicting oral tongue squamous cell carcinoma survival

Head Neck. 2014 Oct;36(10):1481-9. doi: 10.1002/hed.23486. Epub 2014 Jan 13.

Abstract

Background: The purpose of this study was to investigate the prognostic impact of comorbidity and of demographic and pathological factors on oral tongue squamous cell carcinoma (SCC) survival, and to compare the prognostic performance of a new clinicopathological model against the routinely used TNM staging.

Methods: We conducted a retrospective study of demographic, clinical, and pathological information of 166 patients with oral tongue SCC. Cox regression was used for multivariate analysis, model building, and model discriminatory analysis.

Results: Comorbidity had the most significant impact on overall survival (OS; log-rank test, chi-square = 36.34; p < .0001). Comorbidity, tumor dimension >2 cm, and presence of extracapsular spread (ECS) or vascular invasion were independent predictors of survival. A clinicopathological model based on these 4 variables (chi-square = 60.23; p < .0001) was better (c-statistic = 0.736) at predicting survival compared to pathological TNM staging (c-statistic = 0.645).

Conclusion: Comorbidity combined with tumor dimension, ECS, and vascular invasion provide a better prediction of oral tongue SCC survival than TNM staging alone.

Keywords: TNM staging; comorbidity; squamous cell carcinoma; survival; tongue cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Comorbidity
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Tongue Neoplasms / mortality*
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery
  • Young Adult