Staging soft tissue sarcoma of the head and neck: Evaluation of the AJCC 8th edition revised T classifications

Head Neck. 2019 Jul;41(7):2359-2366. doi: 10.1002/hed.25701. Epub 2019 Feb 19.


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.

MeSH terms

  • Aged
  • Algorithms
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Neoplasm Staging / standards*
  • Retrospective Studies
  • SEER Program
  • Sarcoma / mortality
  • Sarcoma / pathology*
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology*
  • United States / epidemiology