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. 2018 Mar:78:64-71.
doi: 10.1016/j.oraloncology.2018.01.013. Epub 2018 Feb 20.

Do we need a different staging system for tongue and gingivobuccal complex squamous cell cancers?

Piyush Gupta  1 , Jocelyn C Migliacci  2 , Pablo H Montero  3 , Daniella Karassawa Zanoni  4 , Jatin P Shah  5 , Snehal G Patel  6 , Ian Ganly  7
Affiliations

Do we need a different staging system for tongue and gingivobuccal complex squamous cell cancers?

Piyush Gupta et al. Oral Oncol. 2018 Mar.

Abstract

Objectives: To determine the need for a separate staging system for gingivobuccal complex squamous cell cancers (GBCSCC) based on 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) data from one institution.

Patients and methods: An Institutional Review Board (IRB)-approved retrospective analysis was performed on an oral cavity cancer patient database. Patients from 1985 to 2012 with primary surgical treatment for biopsy-proven squamous cell cancer (SCC) from either the oral tongue (TSCC Group) or gingivobuccal complex (GBCSCC Group), were selected as two separate subgroups. The clinicopathologic data were used to stage the patients based on the American Joint Committee on Cancer 7th edition. Survival outcomes including 5-year OS, RFS, and DSS were calculated and analyzed. A multivariate analysis was performed to identify if subsite was an independent predictor for the survival outcomes, adjusting for other variables. A p-value of less than .05 was considered statistically significant.

Results: 936 patients with TSCC and 486 patients with GBCSCC were considered eligible for the analysis. Patients with GBCSCC were more likely to be older (p < .001) and presented with more advanced disease (p < .001) compared to patients with TSCC. Unadjusted hazard ratio (HR) suggested GBCSCC had poor OS compared to TSCC. However, after adjusting for other variables, the adjusted HR was not significant (p = .593). There was no difference in 5-year DSS or RFS in either of the study groups.

Conclusion: With similar survival outcomes by stage, there is no justification for using a different staging system for GBCSCC.

Keywords: AJCC; Gingivobuccal; Head and neck cancer; Oral cancer; Prognosis; Retrospective studies; Squamous cell; Staging; Survival; Tongue.

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Conflict of interest statement

Conflict of interest

None.

Figures

None
Recurrence patterns in GBCSCCa and TSCCb cohorts
a- GBCSCC, Gingivobuccal complex squamous cell cancer; b- TSCC, Oral tongue squamous cell cancer; c- RFS, Recurrence Free Survival; d - Gehan-Breslow-Wilcoxon method ; *(n (%) = number of recurrences [percentage from total recurrences])
None
Comparison of survival outcomes for GBCSCCa and TSCCb for overall survival (Figure 2A), disease-specific survival (Figure 2B), and recurrence-free survival (Figure 2C)
a- GBCSCC, Gingivobuccal complex squamous cell cancer; b- TSCC, Oral tongue squamous cell cancer, *p-values - log-rank test.
None
Stage-stratified comparison for overall survival of GBCSCCa and TSCCb
a- GBCSCC, Gingivobuccal complex squamous cell cancer; b- TSCC, Oral tongue squamous cell cancer
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