Abstract 683
Background
The American Joint Committee on Cancer 8th Edition (AJCC 8) for oral cavity squamous cell carcinoma (OCSCC) incorporates depth of invasion (DOI) into the pathologic tumor classification (pT) and pathologic extranodal extension (pENE) into the pathologic nodal classification (pN). We sought to evaluate the incidence and prognostic importance of stage migration as a result of these changes on the AJCC 8 staging system.
Methods
From the National Cancer Database, cohorts were identified from patients with OCSCC undergoing definitive surgery between 2004-2013 for pT (n = 7,184), pN (n = 13,627), and pathologic Stage (pStage; n = 5,580) analysis.
Results
DOI and pENE were prognostic in all groups except AJCC 7 pN3. Upstaging was seen in 12.4% of patients for pT classification, 13.3% for pN classification, and 24.8% for overall pathologic stage grouping. Notably, upstaging led to similar or improved five-year overall survival (5-YR OS) for every AJCC 8 pT/N classification except pStage IVB. AJCC 7 pT1 tumors upstaged to AJCC 8 pT3 tumors had improved overall survival compared to the remainder of the pT3 group (71.7% vs 43.7%, respectively, P < 0.0001). A multivariable analysis of up-staged pT3N0 patients demonstrated a reduced risk of death with receipt of PORT (HR 0.56, 95% CI 0.33-0.95, P = 0.03).
Conclusions
Upstaging is common in AJCC 8, and upstaged tumors demonstrate improved survival; these factors that should be kept in mind when interpreting data using the new staging system. Postoperative radiotherapy may reduce death in newly upstaged pT3N0 patients, and further study is needed in this area.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Yale School of Medicine.
Funding
Research reported in this publication was supported by the National Institute on Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number T35DK104689 (NCJL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This publication was made possible by the Yale School of Medicine Medical Student Fellowship (NCJL).
Disclosure
B. Burtness: Honoraria (self), Research grant / Funding (institution): Advaxis; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Bristol-Myers Squibb; Honoraria (self): IDDI; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Travel / Accommodation / Expenses: Boehringer Ingelheim; Advisory / Consultancy: Celgene; Advisory / Consultancy: Genentech. All other authors have declared no conflicts of interest.
Resources from the same session
2115 - Preclinical in vivo screening to predict responder patients depend on EGFR status
Presenter: Yejin Kim
Session: Poster Display session 3
Resources:
Abstract
3349 - Interplay between miR-17-5p and MALAT-1 Shapes The Cytokine Storm in Triple Negative Breast Cancer (TNBC) Tumor Microenvironment
Presenter: Raghda Soliman
Session: Poster Display session 3
Resources:
Abstract
4014 - Clinical verification on the relationship between lipid metabolism and the immune microenvironment of breast cancer
Presenter: Wataru Goto
Session: Poster Display session 3
Resources:
Abstract
4158 - The clinical and transcriptional signatures of human CD204 reveal an applicable marker for tumor associated macrophage in breast cancer
Presenter: Yunjie He
Session: Poster Display session 3
Resources:
Abstract
5392 - Activated effector T cells co-expressing multiple inhibitory receptors (IRs) are enriched in the tumor immune microenvironment in high grade serous ovarian cancer (HGSOC)
Presenter: Alice Bergamini
Session: Poster Display session 3
Resources:
Abstract
2617 - Oncolytic reovirus as a new anti-tumor strategy in castration resistant prostate cancer
Presenter: Yunlim Kim
Session: Poster Display session 3
Resources:
Abstract
2995 - Dysregulation of helper T lymphocytes in esophageal squamous cell carcinoma (ESCC) patients is highly associated with aberrant production of miR-21
Presenter: Ali Memarian
Session: Poster Display session 3
Resources:
Abstract
3597 - Myeloid derived suppressor cells but not regulatory T cells are associated with adaptive immunity and clinical outcomes in anal squamous cell carcinoma
Presenter: Christophe Borg
Session: Poster Display session 3
Resources:
Abstract
3430 - Evaluation of immune responses among responders (R) and non-responders (non-R) in a humanized mouse model with colorectal cancer (CRC) xenografts treated with combination immunotherapy
Presenter: Juan Marín Jiménez
Session: Poster Display session 3
Resources:
Abstract
1995 - ¬¬Advanced melanoma patients with high CD16+ macrophages have better response and survival to anti-PD-1 based immunotherapy
Presenter: Hansol Lee
Session: Poster Display session 3
Resources:
Abstract