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- Title
The importance of correct stage grouping in oncology. Results of a nationwide study of oropharyngeal carcinoma in The Netherlands.
- Authors
Hart, Augustinus A. M.; Mak-Kregar, Sanja; Hilgers, Frans J. M.; Levendag, Peter C.; Manni, Johannes J.; Spoelstra, Hubert A.; Bruaset, Ingolf A.; Van Der Laan, Bernardus F. A. M.; Annyas, Albert A.; Van Der Beek, Johan M. H.; Van Der Meij, Andel G. L.; Visser, Otto; Hart, A A; Mak-Kregar, S; Hilgers, F J; Levendag, P C; Manni, J J; Spoelstra, H A; Bruaset, I A; van der Laan, B F
- Abstract
<bold>Background: </bold>In the frame of a nationwide study of oropharyngeal carcinoma in the Netherlands (1986-1990), the current International Union Against Cancer 1992/American Joint Committee on Cancer 1988 staging system was evaluated with respect to patient distribution and prognostic value.<bold>Methods: </bold>Data related to epidemiology, treatment and survival from 640 patients referred for primary treatment were analyzed. Staging was first evaluated in a proportional-hazard regression analysis controlled for these data. Next, all possible combinations of T, N, and M were tested in a stepwise backward elimination model until all remaining indicator variables had a P value of less than 0.05. New stages were defined, based on the coefficients of the remaining indicator variables.<bold>Results: </bold>The revised stages revealed two advantages compared with the UICC 1992/AJCC 1988 version: a more balanced distribution of patients (31% in Stage I, 31% in Stage II, 18% in Stage III, 14% in Stage IV, and 5% unknown in the revised staging system versus 7% in Stage I, 17% in Stage II, 24% in Stage III, 50% in Stage IV, and 2% unknown in the UICC 1992/AJCC 1988 staging system), and an improved prognostic discrimination for the disease specific survival (5-year results in the revised staging were 67% in Stage I, 42% in Stage II, 28% in Stage III, and 11% in Stage IV, versus 68% in Stage I, 64% in Stage II, 44% in Stage III and 27% in Stage IV in UICC 1992/AJCC 1988).<bold>Conclusion: </bold>Improvements in the current staging system in patient distribution in the stages in prognostic discrimination is feasible by regrouping the T, N, and M but without redefining the categories themselves.
- Publication
Cancer (0008543X), 1995, Vol 75, Issue 11, p2656
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/1097-0142(19950601)75:11<2656::AID-CNCR2820751103>3.0.CO;2-R