Predictors of clinical‐pathologic stage discrepancy in oral cavity squamous cell carcinoma: A National Cancer Database study

Predictors of clinical‐pathologic stage discrepancy in oral cavity squamous cell carcinoma: A... INTRODUCTIONIn oral cavity squamous cell carcinoma (SCC), several criteria allow estimation of survival outcomes, most importantly tumor classification and anatomic subsite. These factors also allow clinicians to determine treatment options, which have been well‐defined by nationally recognized guidelines. However, these decisions still involve significant clinical judgment, as the accuracy of clinical (presurgical) staging is limited. This is evident from previous studies finding that 35%‐45% of patients with oral cavity SCC present with occult nodal metastasis, the management of which remains controversial. Despite a growing body of literature that repeatedly redefines indications for specific treatment strategies, improvements in survival have been modest. The limitations of clinical staging may contribute to the relatively small improvements in survival rates of oral cavity SCC over the past 40 years compared with other head and neck cancers.Before surgery, the tumor size and extent are assessed by physical examination and imaging via computed tomography (CT), magnetic resonance imaging, or positron emission tomography, depending on the location and degree of disease. This disagreement between clinical and pathological staging of oral cavity SCC can be as high as 32%. Such stage discrepancy may result in significant clinical consequence. For the 23.7% of the patients who were pathologically http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Head & Neck: Journal for the Sciences & Specialties of the Head and Neck Wiley

Predictors of clinical‐pathologic stage discrepancy in oral cavity squamous cell carcinoma: A National Cancer Database study

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1043-3074
eISSN
1097-0347
D.O.I.
10.1002/hed.25065
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONIn oral cavity squamous cell carcinoma (SCC), several criteria allow estimation of survival outcomes, most importantly tumor classification and anatomic subsite. These factors also allow clinicians to determine treatment options, which have been well‐defined by nationally recognized guidelines. However, these decisions still involve significant clinical judgment, as the accuracy of clinical (presurgical) staging is limited. This is evident from previous studies finding that 35%‐45% of patients with oral cavity SCC present with occult nodal metastasis, the management of which remains controversial. Despite a growing body of literature that repeatedly redefines indications for specific treatment strategies, improvements in survival have been modest. The limitations of clinical staging may contribute to the relatively small improvements in survival rates of oral cavity SCC over the past 40 years compared with other head and neck cancers.Before surgery, the tumor size and extent are assessed by physical examination and imaging via computed tomography (CT), magnetic resonance imaging, or positron emission tomography, depending on the location and degree of disease. This disagreement between clinical and pathological staging of oral cavity SCC can be as high as 32%. Such stage discrepancy may result in significant clinical consequence. For the 23.7% of the patients who were pathologically

Journal

Head & Neck: Journal for the Sciences & Specialties of the Head and NeckWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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