Incorporation of log odds of positive lymph nodes into the AJCC TNM classification improves prediction of survival in oral cancer

doi:10.1111/coa.12809

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標題:	Incorporation of log odds of positive lymph nodes into the AJCC TNM classification improves prediction of survival in oral cancer
作者:	Lee, C. -C Lin, Y. -S Kang, B. -H Chang, K. -P Chi, C. -C Lin, M. -Y Su, H. -H Chang, T. -S Chen, H. -C Chen, P. -C Huang, W. -L Huang, C. -, I Chou, P. Yang, C-C
貢獻者:	Kaohsiung Vet Gen Hosp, Dept Otolaryngol Head & Neck Surg Tri Serv Gen Hosp, Sch Med, Natl Def Med Ctr Tri Serv Gen Hosp, Dept Otolaryngol Head & Neck Surg Kaohsiung Vet Gen Hosp, Dept Stomatol Pingtung Christian Hosp, Dept Radiat Oncol Kaohsiung Vet Gen Hosp, Dept Radiat Oncol E Da Hosp, Dept Radiat Oncol Natl Yang Ming Univ, Sch Med, Inst Publ Hlth Chi Mei Med Ctr, Dept Radiat Oncol Natl Sun Yat Sen Univ, Inst Biomed Sci Chia Nan Univ Pharm & Sci, Dept Biotechnol
關鍵字:	Squamous-Cell Carcinoma Gastric-Cancer R0 Resection Colon-Cancer Ratio Number Head Neck Dissection Prognosis
日期:	2017-04
上傳時間:	2018-11-30 15:50:30 (UTC+8)
出版者:	Wiley
摘要:	Objectives: To assess the prognostic performance of a new N classification that incorporates the log odds of positive lymph nodes (LODDS) into the routinely used pathological N classification for oral squamous cell carcinoma (OSCC) patients. Design: Retrospective cohort study utilising LODDS into pN category was performed, and the AJCC TNM stage and T-New N-M stage were compared with respect to 5-year disease-specific survival (DSS) rates. The discriminability was evaluated from the linear trend chi-square test, Akaike information criterion (AIC) and Harrell's c-statistic. Setting: Medical centrer in Taiwan. Participants: A total of 463 patients received primary surgery and neck dissection between 2004 and 2013 for OSCC. Main outcome measures: The discriminability for 5-year DSS rates. Results: The median follow-up period was 54 months, the mean patient age was 54 +/- 11 years and 428 patients (92.4%) were male. The patients with higher LODDS had worse 5-year DSS rates. Incorporation of LODDS into the prognostic model based on the seventh edition of the TNM classification significantly improved discriminative performance for 5-year DSS with a lower AIC (1883 versus 1897), and higher prediction accuracy (Harrell's c-statistic: 0.768 versus 0.764). Conclusions: By utilising a merger of the LODDS and pN classifications to create a new N classification has better discriminatory and predictive ability than pathological TNM staging and could help identify high-risk patients for intense adjuvant therapy.
關聯:	Clinical Otolaryngology, v.42, n.2, pp.425-432
顯示於類別:	[生物科技系(所)] 期刊論文

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