ArticleBMC oral health2026
Stage migration and prognostic refinement of oral squamous cell carcinoma under the AJCC 8th edition staging system: a retrospective cohort study with additional evaluation using the SEER database.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveThe eighth edition of the American Joint Committee on Cancer (AJCC) staging system incorporated pathologic depth of invasion (pDOI) and pathologic extranodal extension (pENE) for prognostic stratification in oral squamous cell carcinoma (OSCC). However, the extent of stage migration and the consistency of survival discrimination across populations remained controversial. This study aimed to evaluate stage migration associated with the AJCC 8th edition, assess its prognostic performance relative to the AJCC 7th edition, and explore potential refinements to the pT classification.
methodsPatient data from the Hospital of Stomatology, Sun Yat-sen University (2014-2021), and the SEER database (2018-2019) were used. Overall survival (OS) and disease-specific survival (DSS) were estimated using the Kaplan-Meier method to compare the prognostic outcomes of the AJCC 7th and 8th editions. An exploratory refinement of the AJCC 8th pT classification was then developed using the SYSU-OSCC cohort. Multivariable Cox regression was used to assess the prognostic value of different cutoff thresholds, and a refined pT classification was proposed. Model performance was evaluated according to the established Groome criteria.
resultsIn the SYSU-OSCC cohort, upstaging was observed in 31.3% of patients for pT classification, 10.9% for pN classification, and 31.4% for overall pathologic stage. Compared with the AJCC 7th edition, the AJCC 8th showed clearer prognostic separation between pT3 and pT4a in the SYSU-OSCC cohort (5-year OS rates: 69.2% vs. 51.7%, p = 0.012; 5-year DSS rates: 76.6% vs. 62.0%, p = 0.014) and improved survival discrimination, particularly at intermediate and advanced-stage disease. However, prognostic overlap persisted between pT1 and pT2 categories (5-year OS rates: 82.4% vs. 76.9%, p = 0.14; 5-year DSS rates: 87.0% vs. 83.9%, p = 0.45). In the SEER-OSCC cohort, however, risk separation between pT3 and pT4a remained limited (3-year OS rates: 58.1% vs. 54.3%, p = 0.16; 3-year DSS rates: 64.5% vs. 63.4%, p = 0.41). Based on the SYSU-OSCC cohort, tumors with pDOI > 5 mm and ≤ 10 mm and a tumor size ≤ 2 cm were proposed for reclassification into the pT1 category. In the SYSU-OSCC training and internal validation cohorts, the exploratory refined classification showed improved prognostic performance compared with the original AJCC 8th edition.
conclusionThe AJCC 8th edition improved prognostic stratification in OSCC, particularly for intermediate and advanced-stage disease. However, residual prognostic overlap remained between specific pT categories. The exploratory refinement of selected pT thresholds may modestly improve prognostic accuracy. However, rigorous validation in larger independent external cohorts is required before its clinical applicability can be determined.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.