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TNM‐based stage groupings in head and neck cancer: Application in cancer of the hypopharynx
Author(s) -
Hall Stephen F.,
Groome Patti A.,
Irish Jonathan,
O'Sullivan Brian
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20917
Subject(s) - stage (stratigraphy) , head and neck cancer , medicine , cancer , tnm staging system , oncology , hazard ratio , population , staging system , environmental health , paleontology , confidence interval , biology
Background. The purpose of this study was to test the Union Internationale Contre le Cancer (UICC)/TNM category–based head and neck cancer stage grouping systems proposed in the literature for their ability to create clinically relevant prognostic groups of like‐patients with cancer of the hypopharynx. Methods. Population‐based retrospective survival study of 595 patients with squamous cell carcinoma of the hypopharynx across Ontario, Canada, from January 1990 to January 2000. The grouping systems of UICC/TNM, T and N Integer Score (TANIS), Hart, Berg, Snyderman, Kiricuta, and Hall were tested and compared for prognostic ability using hazard consistency, hazard discrimination, percent variance explained, outcome prediction, and balance. Results. All 8 systems predicted disease‐specific survival. The system proposed by Snyderman performed the best, and UICC/TNM sixth edition did not perform as well as most. Conclusion. The UICC/TNM stage group classification, although successful in creating statistically distinct groups, did not perform as well as other stage grouping systems, continuing a theme that has been reported previously. © 2008 Wiley Periodicals, Inc. Head Neck, 2009