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Titolo:
A comparison of published head and neck stage groupings in carcinomas of the tonsillar region
Autore:
Groome, PA; Schulze, KM; Mackillop, WJ; Grice, B; Goh, C; Cummings, BJ; Hall, SF; Liu, FF; Payne, D; Rothwell, DM; Waldron, JN; Warde, PR; OSullivan, B;
Indirizzi:
Queens Univ, Radiat Oncol Res Unit, Kingston Gen Hosp, Kingston, ON K7L 2V7, Canada Queens Univ Kingston ON Canada K7L 2V7 Hosp, Kingston, ON K7L 2V7, Canada Univ Toronto, Princess Margaret Hosp, Toronto, ON, Canada Univ Toronto Toronto ON Canada incess Margaret Hosp, Toronto, ON, Canada
Titolo Testata:
CANCER
fascicolo: 6, volume: 92, anno: 2001,
pagine: 1484 - 1494
SICI:
0008-543X(20010915)92:6<1484:ACOPHA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
OROPHARYNGEAL CARCINOMA; PREDICTING PROGNOSIS; PROBABILITY SCORE; TNM; SURVIVAL; CANCER; RELIABILITY; REGRESSION; SYSTEM; TANIS;
Keywords:
American Joint Committee on Cancer (AJCC) International Union Against Cancer (UICC); carcinomas of the tonsil; cancer staging; TNM; classification; construct validity; prognosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Groome, PA Queens Univ, Radiat Oncol Res Unit, Kingston Gen Hosp, Apps Level 4, Kingston, ON K7L 2V7, Canada Queens Univ Apps Level 4 Kingston ON Canada K7L 2V7 2V7, Canada
Citazione:
P.A. Groome et al., "A comparison of published head and neck stage groupings in carcinomas of the tonsillar region", CANCER, 92(6), 2001, pp. 1484-1494

Abstract

BACKGROUND. The combination of T, N, and M classifications into stage groupings was designed to facilitate a number of activities including: the estimation of prognosis and the comparison of therapeutic interventions among similar groups of cases. The authors tested the UICC/AJCC 5th edition stage grouping and seven other TNM-based groupings proposed for head and neck cancer to determine their ability to meet these expectations in a specific site: carcinoma of the tonsillar region. METHODS. The authors defined four criteria to assess each stage grouping scheme: 1) The subgroups defined by T and N comprising a given group within a grouping scheme have similar survival rates (hazard consistency); 2) The survival rates differ across the groups (hazard discrimination); 3) The prediction of cure is high (outcome prediction); and 4) The distribution of patients among the groups is balanced. The authors identified or derived a measure for each criterion and the findings were summarized using a scoring system. The range of scores was from 0 (best) to 7 (worst). Data were from aretrospective chart review on 642 cases of carcinoma of the tonsillar region treated with radiotherapy for cure at the Princess Margaret Hospital from 1970-1991. None of the patients had distant metastases. RESULTS. The scheme proposed by Synderman and Wagner, which was published in Otolaryngology Head and Neck Surgery in 1995 (vol.112, pages 691-4), scored best at 1.2. The UICC/AJCC scheme scored worst at 6.1. The hazard consistency ranged from a 3.1% average survival difference to 6.7% across the 8 schemes. The hazard discrimination measure varied by 28% from the best to worst scheme. Prediction varied by up to almost twofold across the schemes assessed. The distribution of patients varied from expected by between 0.13%and 0.57%. CONCLUSION. UICC/AJCC stage groupings were defined without empirical investigation. When tested, this scheme did not perform as well as any of seven empirically-derived schemes the authors evaluated, The results of the current study suggest that the usefulness of the TNM system can be enhanced by optimizing the design of stage groupings through empirical investigation. (C) 2001 American Cancer Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 02:30:58