Online citations, reference lists, and bibliographies.

Pathologically Determined Tumor Volume Vs Pathologic T Stage In The Prediction Of Outcome After Surgical Treatment Of Oropharyngeal Squamous Cell Carcinoma.

Iain J Nixon, Frank L. Palmer, Paul Lakin, Michael W Kattan, Nancy Y. Lee, Ian Ganly
Published 2013 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
IMPORTANCE Traditional prognostic models for squamous cell carcinoma of the head and neck are based on the TNM staging system. However, there is growing evidence that tumor volume (TV) may be a more accurate predictor of outcome. OBJECTIVE To determine whether pathologic TV (pTV) in patients with oropharyngeal squamous cell carcinoma treated surgically is a more significant predictor of outcome compared with pathologic tumor (pT) stage. DESIGN, SETTING, AND PARTICIPANTS Review of patients whose treatment was managed between January 1, 1985, and December 2005 at a US tertiary referral cancer center. The participants included 159 patients who had undergone primary surgery for oropharyngeal squamous cell carcinoma and had 3 dimensions reported on histopathologic testing. MAIN OUTCOMES AND MEASURES The pTV was calculated as the product of the 3 dimensions expressed in cubic centimeters. For comparison of pT stage with pTV in outcome prediction, concordance indexes were generated using the bootstrap method (n = 1000) to quantify the predictive accuracy of recurrence and survival outcomes. Concordance indexes were then compared and a significant difference was considered when P < .05. RESULTS The median age of the patients was 59 years (range, 22-84 years) and 106 were male (67%). Sites of the tumors were base of the tongue (86 patients [54%]), tonsil (48 [30%]), soft palate (24 [15%]), and posterior pharyngeal wall (1 [1%]). The median follow-up time was 64 months (range, 1-272 months). The median tumor volume was 6.8 cm3 (range, 0.1-162.5 cm³). Pathologic TV was a significant predictor of disease-specific mortality. Unlike pT stage, pTV was a significant predictor of local recurrence, regional recurrence, and distant recurrence. Comparison of concordance indexes showed that pTV was a significantly better predictor of disease-specific mortality, local recurrence, and distant recurrence (all P < .05). CONCLUSIONS AND RELEVANCE Pathologic TV outperforms pT stage in the prediction of outcome following surgical treatment of oropharyngeal cancer. Tumor volume should be considered in the design of prospective surgical trials.
This paper references
Quantitative analysis from CT is prognostic for local control of supraglottic carcinoma.
Jonathan Kraas (2001)
An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center: a staging system in need of repair.
Kristina R Dahlstrom (2013)
Volumetric staging (VS) is superior to TNM and AJCC staging in predicting outcome of head and neck cancer treated with IMRT
Gabriela Studer (2007)
Tumor volume as a prognostic factor in oropharyngeal squamous cell carcinoma treated with primary radiotherapy.
Mark J Been (2008)
Value of computed tomography-based tumor volume as a predictor of outcomes in hypopharyngeal cancer after treatment with definitive radiotherapy.
Shang-Wen Chen (2006)
Intensity-modulated radiation therapy in oropharyngeal carcinoma: effect of tumor volume on clinical outcomes.
Benjamin H Lok (2012)
Staging of head and neck cancers: is it time to change the balance between the ideal and the practical?
Snehal G. Patel (2008)
Prognostic value of pretreatment CT regarding local control in oropharyngeal cancer after primary surgical resection [ in German ]
M Keberle (2003)
Volumetric analysis of tumor extent in nasopharyngeal carcinoma and correlation with treatment outcome.
Daniel T T Chua (1997)
Transoral resection of pharyngeal cancer: summary of a National Cancer Institute Head and Neck Cancer Steering Committee Clinical Trials Planning Meeting, November 6-7, 2011, Arlington, Virginia.
David Adelstein (2012)
The impact of primary tumor volume on local control for oropharyngeal squamous cell carcinoma treated with radiotherapy.
R M Nathu (2000)
[Prognostic value of pretreatment CT regarding local control in oropharyngeal cancer after primary surgical resection].
Marc Keberle (2003)
Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume.
K S Clifford Chao (2004)
Usefulness of Tumor Volumetry as a Prognostic Factor of Survival in Head and Neck Cancer
Ralf Kurek (2003)
Parameters that predict local control after definitive radiotherapy for squamous cell carcinoma of the head and neck.
William M Mendenhall (2003)
Preradiotherapy computed tomography as a predictor of local control in supraglottic carcinoma.
Anthony A. Mancuso (1999)
Evaluation of pretreatment computed tomography as a predictor of local control in T1/T2 pyriform sinus carcinoma treated with definitive radiotherapy.
F A Pameijer (1998)
Prognostic indicators for survival in head and neck squamous cell carcinomas: analysis of a series of 621 cases.
Christophe Le Tourneau (2005)
A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma.
Anthony Po-Wing Yuen (2000)
Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer
James A. Stockman (2012)
Predicting the local outcome of glottic squamous cell carcinoma after definitive radiation therapy: value of computed tomography-determined tumour parameters.
Robert Hermans (1999)
Human papillomavirus (HPV) DNA in tonsillar cancer: clinical correlates, risk of relapse, and survival.
Hanna Mellin (2000)
Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins.
Gregory Weinstein (2012)
TNM Classification of Malignant Tumours
Leslie Sobin (1987)

This paper is referenced by
The impact of HPV infection, smoking history, age and operability of the patient on disease-specific survival in a geographically defined cohort of patients with oropharyngeal squamous cell carcinoma
Borghild Ljøkjel (2014)
Prognostic implications of pathologically determined tumour volume in glottic carcinomas treated by transoral laser microsurgery.
Mark D Wilkie (2015)
Comparison of tumor volume, thickness, and T classification as predictors of outcomes in surgically treated squamous cell carcinoma of the oral tongue
Manish Mair (2018)
Pretreatment metabolic tumor volume as a prognostic factor in HPV‐associated oropharyngeal cancer in the context of AJCC 8th edition staging
John M Floberg (2018)
Styloglossus muscle: a critical landmark in head and neck oncology.
Ollivier Laccourreye (2018)
CT-based volumetric tumor growth velocity: A novel imaging prognostic indicator in oropharyngeal cancer patients receiving radiotherapy.
Subha Perni (2016)
Treatment Outcomes for T4 Oropharyngeal Squamous Cell Carcinoma.
Joseph Zenga (2015)
Tumor volume as an independent predictive factor of worse survival in patients with oral cavity squamous cell carcinoma
Chin Shien Lin (2017)
Cyclin D1 and Ki-67 expression correlates to tumor staging in tongue squamous cell carcinoma
Eduardo-Pereira Guimarães (2015)
34 – Advanced HPV-Related Oropharynx Cancer
Krzysztof J. Misiukiewicz (2018)
Tumor volume as a predictor of survival in human papillomavirus-positive oropharyngeal cancer.
Kara S. Davis (2016)
Styloglossus muscle: a critical landmark in head and neck oncology
O. Laccourreyea (2019)
Pretreatment tumor volume and tumor sphericity as prognostic factors in patients with oral cavity squamous cell carcinoma.
Achille Tarsitano (2019)
Accuracy and feasibility of estimated tumour volumetry in primary gastric gastrointestinal stromal tumours: validation using semiautomated technique in 127 patients
Sree Harsha Tirumani (2015)
Use of a Multidisciplinary Design Optimization Approach to Model Treatment Decisions in Oropharyngeal Cancer
Robert T. Aarhus (2018)
Le muscle styloglosse : un repère clef en cancérologie cervico-faciale
Ollivier Laccourreye (2018)
Semantic Scholar Logo Some data provided by SemanticScholar