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
3988 - Basal NK activity and early Treg function inhibition predicts Nivolumab responsiveness in metastatic renal cancer patients (REVOLUTION) trial.
Presenter: Sara Santagata
Session: Poster Display session 3
Resources:
Abstract
2142 - Low NK Cell Abundance Correlates with High Expression of PD-1 in CD8+ T Cells
Presenter: Moon Hee Lee
Session: Poster Display session 3
Resources:
Abstract
5501 - Tobacco smoking is associated with the immune suppressive microenvironment in head and neck squamous cell carcinoma (HNSCC)
Presenter: Christine Chung
Session: Poster Display session 3
Resources:
Abstract
5726 - Evaluation of Antibody-Dependent Cell Cytotoxicity (ADCC) in lung cancer cell lines treated with combined anti-EGFR and anti-PD-L1 therapy.
Presenter: Francesca Sparano
Session: Poster Display session 3
Resources:
Abstract
2534 - Radiomic Signatures for Identification of Tumors Sensitive to Nivolumab or Docetaxel in Squamous Non-Small Cell Lung Cancer (sqNSCLC)
Presenter: Laurent Dercle
Session: Poster Display session 3
Resources:
Abstract
3366 - Analysis of gut microbiota in advanced non-small cell lung cancer (NSCLC) patients treated with immune-checkpoints blockers
Presenter: FEIYU ZHANG
Session: Poster Display session 3
Resources:
Abstract
2089 - Pathogenesis of Myocarditis Following Treatment with Immune Checkpoint Inhibitors in a Cynomolgus Monkey Model
Presenter: Changhua Ji
Session: Poster Display session 3
Resources:
Abstract
4463 - Effects of dietary restriction in cancer patients receiving irinotecan
Presenter: Ruben Van Eerden
Session: Poster Display session 3
Resources:
Abstract
4841 - Investigating the Link between Burn Injury and Tumorigenesis
Presenter: Lucy Barrett
Session: Poster Display session 3
Resources:
Abstract
4619 - Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio in male breast cancer patients
Presenter: Joanna Huszno
Session: Poster Display session 3
Resources:
Abstract