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Validation of the eighth edition American Joint Committee on Cancer staging system for human papillomavirus‐associated oropharyngeal cancer
Author(s) -
Cramer John D.,
Hicks Kate E.,
Rademaker Alfred W.,
Patel Urjeet A.,
Samant Sandeep
Publication year - 2018
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.24974
Subject(s) - concordance , medicine , human papillomavirus , cancer , cancer staging , stage (stratigraphy) , pathological , oncology , pathological staging , ajcc staging system , staging system , biology , paleontology
Background The eighth edition American Joint Committee on Cancer (AJCC) staging manual includes major changes in staging of oropharyngeal cancer (OPC). We evaluated the new staging system in order to validate this shift in classification. Methods We used the National Cancer Database (NCDB) to identify patients with human papillomavirus‐associated (HPV‐positive) OPC from 2010‐2013. We restaged patients using the eighth edition guidelines and compared them with those from the seventh edition. We calculated stage‐specific overall survival and concordance indices. Results We identified 15 116 patients with a median follow‐up period of 29.1 months. Clinical and pathological staging changed for 93.9% and 91.7% of patients, respectively. Survival concordance indices for both clinical (0.621‐0.656) and pathological (0.640‐0.663) staging were improved in the eighth edition compared to the seventh edition. Conclusion The eighth edition guidelines have profoundly altered staging of HPV‐positive OPC and seem to demonstrate improved survival discrimination.