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Discordance between Clinical and Pathological TNM Classifications in Patients with Oropharyngeal Cancer – Influence on Treatment and Prognosis


Authors: P. Kordač 1;  D. Kalfeřt 1,2;  K. Smatanová 1;  J. Laco 3;  M. Vošmik 4;  P. Čelakovský 1;  Viktor Chrobok 1
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN Hradec Králové 1;  ORL, foniatrie, sluchová protetika s.  r.  o., Plzeň 2;  Fingerlandův ústav patologie, LF UK a FN Hradec Králové 3;  Klinika onkologie a radioterapie LF UK a FN Hradec Králové 4
Published in: Klin Onkol 2016; 29(2): 122-126
Category: Original Articles
doi: https://doi.org/10.14735/amko2016122

Overview

Background:
The aim of this study was to determine the percentage of discordance between clinical (c) and pathological (p) TNM classifications in cases of oropharyngeal carcinoma and whether it influences recurrence rate and prognosis of primary disease.

Materials and Methods:
Fifty-one patients with oropharyngeal carcinoma who underwent primary surgical treatment were included in this retrospective study. Clinical TNM was determined on the basis of clinical examinations and imaging (US, CT, or MRI), and pathological TNM was determined by a histopathologist (analysis of the primary tumor and neck lymph nodes). Concordance and discordance were statistically evaluated. As potential prognostic factors, we statistically analyzed tumor recurrence, specific and nonspecific patient survival, patient age, extent of primary tumor, lymph node positivity, number of removed lymph nodes, and positive tumor margins.

Results:
Discordance in the TNM classification was found in 27 cases. Disease-free survival was shorter in patients with discordance in T, and this was statistically significant (p = 0.034). Six patients died due to primary disease (11.8%). Disease-specific survival was at the limit of statistical significance (p = 0.069).

Conclusions:
Discordance between clinical and pathological TNM classifications was 52.9% patients with oropharyngeal carcinoma. Discordance in T is a potential prognostic factor. Improvement in cancer treatment to some extent relies on preoperative staging and should influence the decision about whether or not to administer adjuvant oncological treatment.

Key words:
TNM staging – clinical TNM classification – pathological TNM classification – oropharynx cancer – prognosis

This study was supported by project of the Czech Ministry of Health project conceptual development research organization No. 00179906 and grant PRVOUK P37/11.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
18. 9. 2015

Accepted:
1. 11. 2015


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