Risk stratification in oral squamous cell carcinoma using staging of the eighth American Joint Committee on Cancer: Systematic review and meta-analysis

Head Neck. 2020 Oct;42(10):3002-3017. doi: 10.1002/hed.26344. Epub 2020 Jun 17.

Abstract

The eighth edition of the American Joint Committee on Cancer (AJCC8) staging manual has major changes in oral squamous cell carcinoma (OSCC). We searched PubMed, OvidMedline, Scopus, and Web of Science for studies that examined the performance of AJCC8 in OSCC. A total of 40 808 patients were included in the studies of our meta-analysis. A hazard ratio (HR) of 1.87 (95%CI 1.78-1.96) was seen for stage II, 2.65 (95%CI 2.51-2.80) for stage III, 3.46 (95%CI 3.31-3.61) for stage IVa, and 7.09 (95%CI 4.85-10.36) for stage IVb. A similar gradual increase in risk was noted for the N classification. For the T classification, however, there was a less clear variation in risk between T3 and T4. AJCC8 provides a good risk stratification for OSCC. Future research should examine the proposals introduced in the published studies to further improve the performance of AJCC8.

Keywords: N classification; T classification; TNM stage; depth of invasion (DOI); eighth edition American Joint Committee on Cancer (AJCC 8); extranodal extension; oral squamous cell carcinoma (OSCC); prognosis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / therapy
  • Head and Neck Neoplasms*
  • Humans
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / therapy
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • United States / epidemiology