Evidence map›Paper›PMID 37751180›Full record

ArticleCancer2024

Development and validation of a novel TNM staging N-classification of oral cavity squamous cell carcinoma.

John R de Almeida, Jie Susie Su, Mirko Manojlovic Kolarski, Tra Truong, Ilan Weinreb, Bayardo Perez-Ordonez, Stephen M Smith, Ali Hosni, Snehal Patel, Cristina Valero and 15 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

25 authors.

John R de AlmeidaDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-1546-5033
Jie Susie SuDepartment of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Mirko Manojlovic KolarskiDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Ontario, Canada.
Tra TruongDepartment of Pathology, University Health Network, Toronto, Ontario, Canada.
Ilan WeinrebDepartment of Pathology, University Health Network, Toronto, Ontario, Canada.
Bayardo Perez-OrdonezDepartment of Pathology, University Health Network, Toronto, Ontario, Canada.
Stephen M SmithDepartment of Pathology, University Health Network, Toronto, Ontario, Canada.
Ali HosniDepartment of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.
Snehal PatelHead and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.ORCID 0000-0001-9775-5132
Cristina ValeroHead and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.ORCID 0000-0003-3397-2888
Bin XuDepartment of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.ORCID 0000-0003-4638-9835
Ronald GhosseinDepartment of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Nora KatabiDepartment of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Jonathan ClarkDepartment of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Tsu-Hui Hubert LowDepartment of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
Ruta GuptaSydney Medical School, Faculty of Medicine and Health Sciences, the University of Sydney, Sydney, New South Wales, Australia.
Evan M GraboyesDepartment of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0003-3766-468X
Joel DaviesDepartment of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Mary RichardsonDepartment of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA.
Vishu PashamDepartment of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA.
Rachel JesterDepartment of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA.
David P GoldsteinDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Ontario, Canada.
Shao Hui HuangDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Ontario, Canada.
Wei XuDepartment of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Brian O'SullivanDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Ontario, Canada.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Harry Barberian Scholarship FundNational Institutes of Health, National Cancer Institute CA008748NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundFor oral cavity squamous cell carcinoma (OSCC), extent of extranodal extension (ENE) (minor, ≤2 mm; major, >2 mm) is differentially prognostic, whereas limitations exist with the 8th edition of American Joint Committee on Cancer/International Union Against Cancer TNM N-classification (TNM-8-N).

methodsResected OSCC patients at four centers were included and extent of ENE was recorded. Thresholds for optimal overall survival (OS) discrimination of lymph node (LN) features were established. After dividing into training and validation sets, two new N-classifications were created using 1) recursive partitioning analysis (RPA), and 2) adjusted hazard ratios (aHRs) and were ranked against TNM-8-N and two published proposals.

resultsA total of 1460 patients were included (pN0: 696; pN+: 764). Of the pN+ cases, 135 (18%) had bilateral/contralateral LNs; 126 (17%) and 244 (32%) had minor and major ENE, and two (0.3%) had LN(s) >6 cm without ENE (N3a). LN number (1 and >1 vs. 0: aHRs, 1.92 [95% confidence interval (CI), 1.44-2.55] and 3.21 [95% CI, 2.44-4.22]), size (>3 vs. ≤3 cm: aHR, 1.88 [95% CI, 1.44-2.45]), and ENE extent (major vs. minor: aHR, 1.40 [95% CI, 1.05-1.87]) were associated with OS, whereas presence of contralateral LNs was not (aHR, 1.05 [95% CI, 0.81-1.36]). The aHR proposal provided optimal performance with these changes to TNM-8-N: 1) stratification of ENE extent, 2) elimination of N2c and 6-cm threshold, and 3) stratification of N2b by 3 cm threshold.

conclusionA new N-classification improved staging performance compared to TNM-8-N, by stratifying by ENE extent, eliminating the old N2c category and the 6 cm threshold, and by stratifying multiple nodes by size.

Indexed as

Carcinoma, Squamous CellHead and Neck NeoplasmsMouth NeoplasmsHumansLymph NodesNeoplasm StagingPrognosisRetrospective StudiesSquamous Cell Carcinoma of Head and Neckextent of extranodal extensionextranodal extensionN classificationnumber of nodesoral cancerstaging

Identifiers

PMID37751180
PMCPMC13274953

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.