Background: The American Joint Committee on Cancer (AJCC) has proposed new T classifications for head and neck sarcomas in the 8th edition of the AJCC Cancer Staging Manual, but these classifications have not been evaluated for prognostic utility in tumor staging.
Methods: The predictive ability of revised AJCC T classifications was evaluated by nonlinear multivariable regression using records from the Surveillance, Epidemiology, and End Results database (N = 2756). A proposed staging algorithm was developed using a subset of records and compared to the AJCC 7th edition using a separate validation dataset.
Results: Categorization of tumor size using revised AJCC 8th edition T classifications accurately reflected the predictive information of this intrinsically continuous variable. A proposed staging system based on revised AJCC T classifications showed significant improvement in clinical performance compared to the previous AJCC 7th edition staging system.
Conclusions: Stratifying risk of sarcoma-specific death by categorization of tumor size is informative for head and neck sarcoma. A staging algorithm based on revised AJCC 8th edition T classifications is validated and proposed for further evaluation in staging sarcomas of the head and neck.
Keywords: SEER program; head and neck neoplasms; prognosis; soft tissue sarcoma; tumor staging.
© 2019 Wiley Periodicals, Inc.