The 8th TNM classification for oral squamous cell carcinoma: What is gained, what is lost, and what is missing.

Davide Mattavelli, Marco Ferrari, Stefano Taboni, Riccardo Morello, Alberto Paderno, Vittorio Rampinelli, Francesca Del Bon, Davide Lombardi, Alberto Grammatica, Paolo Bossi, Alberto Deganello, Cesare Piazza, Piero Nicolai

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OBJECTIVES: The 8th TNM edition remarkably changed the classification of T and N categories for oral squamous cell carcinoma (OSCC). The present study aims at evaluating the improvement in prognostic power compared to the 7th edition, pros and cons of the modifications, and parameters deserving consideration for further implementations. MATERIALS AND METHODS: All OSCCs treated with upfront surgery at our institution between 2002 and 2017 were included. Demographics, clinical-pathological and treatment variables were retrieved. All tumors were classified according to both the 7th and 8th TNM edition, and patients were grouped according to the shift in T category and stage. Survivals were calculated with the Kaplan-Meier method. Univariate and multivariate analysis were carried out. Receiver Operating Characteristics (ROC) curve analyses were performed to find the best cut-off of DOI (in patients with DOI textgreater 10 mm) and number of involved nodes (in positive neck patients). RESULTS: 244 patients were included. T, N categories, and stage changed in 59.2 20.5 and 49.1 respectively; 41.5year overall (OS), disease-specific, recurrence-free (RFS) survivals were 60.5 70.9 59.8 respectively. According to ROC curves, DOI textgreater 20 mm and 4 positive nodes were the best cutoffs for OS and RFS. CONCLUSION: The novelties introduced in 8th TNM edition were positive. DOI textgreater 20 mm for T4 definition and number of positive nodes (0, textless4, 4 or more) for N classification emerged as the most urgent factors to be implemented.
Original languageEnglish
JournalOral Oncology
Publication statusPublished - Dec 1 2020

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