TY - JOUR
T1 - Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma
T2 - A National Cancer Database Study
AU - Kılıç, Suat
AU - Kılıç, Sarah S.
AU - Shah, Kajal P.
AU - Eloy, Jean Anderson
AU - Baredes, Soly
AU - Mahmoud, Omar M.
AU - Park, Richard Chan Woo
N1 - Publisher Copyright:
© 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Objective: To determine the frequency, associated factors, and prognosis of clinicopathologic stage discrepancy in oropharyngeal squamous cell carcinoma (OPSCC). Study Design: Retrospective study using a national database. Setting: National Cancer Database. Subjects and Methods: Cases of OPSCC diagnosed between January 1, 2004, and December 31, 2013, with full clinical and pathologic staging information available were identified. Demographic, clinicopathologic, and treatment variables associated with overall stage discrepancy were identified by multivariate logistic regression analysis. Results: In total, 7731 cases of OPSCC were identified. Overall stage discrepancy was present in 30.2% of cases (21.9% upstaging, 8.2% downstaging). A total of 13.1% of cases were T-upstaged, and 10.5% of cases were T-downstaged; 22.9% of cases were N-upstaged, and 8.6% of cases were N-downstaged. Upstaging by overall stage was associated with a high Charlson-Deyo score, high tumor grade, number of lymph nodes examined, and increasing tumor size. No factors were positively associated with downstaging. High tumor grade was negatively associated with downstaging. For stage II, III, and IVA tumors, upstaging was associated with poorer OS. Conclusion: Clinicopathologic stage discrepancy is common in OPSCC and is likely attributable to insensitive clinical staging techniques as well as to intrinsic tumor biologic properties. Upstaging is associated with poorer prognosis, which is likely due to advancement of disease.
AB - Objective: To determine the frequency, associated factors, and prognosis of clinicopathologic stage discrepancy in oropharyngeal squamous cell carcinoma (OPSCC). Study Design: Retrospective study using a national database. Setting: National Cancer Database. Subjects and Methods: Cases of OPSCC diagnosed between January 1, 2004, and December 31, 2013, with full clinical and pathologic staging information available were identified. Demographic, clinicopathologic, and treatment variables associated with overall stage discrepancy were identified by multivariate logistic regression analysis. Results: In total, 7731 cases of OPSCC were identified. Overall stage discrepancy was present in 30.2% of cases (21.9% upstaging, 8.2% downstaging). A total of 13.1% of cases were T-upstaged, and 10.5% of cases were T-downstaged; 22.9% of cases were N-upstaged, and 8.6% of cases were N-downstaged. Upstaging by overall stage was associated with a high Charlson-Deyo score, high tumor grade, number of lymph nodes examined, and increasing tumor size. No factors were positively associated with downstaging. High tumor grade was negatively associated with downstaging. For stage II, III, and IVA tumors, upstaging was associated with poorer OS. Conclusion: Clinicopathologic stage discrepancy is common in OPSCC and is likely attributable to insensitive clinical staging techniques as well as to intrinsic tumor biologic properties. Upstaging is associated with poorer prognosis, which is likely due to advancement of disease.
KW - Database
KW - NCDB
KW - National Cancer Database
KW - clinical stage
KW - discrepancy
KW - downstaging
KW - neoadjuvant chemotherapy
KW - nodal upstaging
KW - oropharynx
KW - pathologic stage
KW - squamous cell carcinoma
KW - upstaging
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UR - http://www.scopus.com/inward/citedby.url?scp=85041627349&partnerID=8YFLogxK
U2 - 10.1177/0194599817736501
DO - 10.1177/0194599817736501
M3 - Article
C2 - 29039250
AN - SCOPUS:85041627349
SN - 0194-5998
VL - 158
SP - 309
EP - 318
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -