Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma

Abstract Background A universally acknowledged cancer staging system considering all aspects of the T‐, N‐, and M‐classifications for middle ear squamous cell carcinoma (MESCC) remains absent, limiting the clinical management of MESCC patients. Materials and Methods A total of 214 MESCC patients wer...

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Autores principales:	Ke Qiu, Wendu Pang, Jianqing Qiu, Junhong Li, Danni Cheng, Yufang Rao, Yijun Dong, Minzi Mao, Qiurui Liu, Xiaosong Mu, Wei Zhang, Wei Xu, Jianjun Ren, Yu Zhao
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	middle ear squamous cell carcinoma prognoses SEER staging scheme Stell’s classification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/194a421b81544441af5b856a0d5ec38b
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spelling	oai:doaj.org-article:194a421b81544441af5b856a0d5ec38b2021-11-22T09:08:47ZEvaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma2045-763410.1002/cam4.4306https://doaj.org/article/194a421b81544441af5b856a0d5ec38b2021-11-01T00:00:00Zhttps://doi.org/10.1002/cam4.4306https://doaj.org/toc/2045-7634Abstract Background A universally acknowledged cancer staging system considering all aspects of the T‐, N‐, and M‐classifications for middle ear squamous cell carcinoma (MESCC) remains absent, limiting the clinical management of MESCC patients. Materials and Methods A total of 214 MESCC patients were extracted from the SEER (the Surveillance, Epidemiology, and End Results) database between 1973 and 2016. The relationships between patient’s characteristics and prognoses were analyzed by Kaplan–Meier and Cox proportional hazards regression models. Novel staging schemes for MESCC were designed by adjusted hazard ratio (AHR) modeling method according to the combinations of Stell’s T‐classification and the eighth AJCC N‐ and M‐classifications, of which performances were evaluated based on five criteria: hazard consistency, hazard discrimination, explained variation, likelihood difference, and balance. Results T‐classification was the most significant prognostic factor for MESCC patients in multivariable analysis (p = 0.021). The N‐ and M‐classifications also had obvious prognostic effect but were not statistically significant by multivariate analysis due to the limited metastasis events. Three novel staging schemes (AHR‐Ⅰ–Ⅲ models, different combination of T‐ and N‐classifications) and ST (solely derived from Stell’s T‐classification) were developed, among which the AHR‐Ⅰ staging scheme performed best. Conclusions Tumor extension, quantified by Stell’s T‐classification, is the most significant prognostic factor for MESCC patients. However, our AHR‐Ⅰ staging scheme, a comprehensive staging scheme that integrating T‐, N‐, and M‐classifications, might be an optimal option for clinical practitioners to predict MESCC patients’ prognosis and make proper clinical decisions.Ke QiuWendu PangJianqing QiuJunhong LiDanni ChengYufang RaoYijun DongMinzi MaoQiurui LiuXiaosong MuWei ZhangWei XuJianjun RenYu ZhaoWileyarticlemiddle ear squamous cell carcinomaprognosesSEERstaging schemeStell’s classificationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 22, Pp 7958-7967 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	middle ear squamous cell carcinoma prognoses SEER staging scheme Stell’s classification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	middle ear squamous cell carcinoma prognoses SEER staging scheme Stell’s classification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Ke Qiu Wendu Pang Jianqing Qiu Junhong Li Danni Cheng Yufang Rao Yijun Dong Minzi Mao Qiurui Liu Xiaosong Mu Wei Zhang Wei Xu Jianjun Ren Yu Zhao Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
description	Abstract Background A universally acknowledged cancer staging system considering all aspects of the T‐, N‐, and M‐classifications for middle ear squamous cell carcinoma (MESCC) remains absent, limiting the clinical management of MESCC patients. Materials and Methods A total of 214 MESCC patients were extracted from the SEER (the Surveillance, Epidemiology, and End Results) database between 1973 and 2016. The relationships between patient’s characteristics and prognoses were analyzed by Kaplan–Meier and Cox proportional hazards regression models. Novel staging schemes for MESCC were designed by adjusted hazard ratio (AHR) modeling method according to the combinations of Stell’s T‐classification and the eighth AJCC N‐ and M‐classifications, of which performances were evaluated based on five criteria: hazard consistency, hazard discrimination, explained variation, likelihood difference, and balance. Results T‐classification was the most significant prognostic factor for MESCC patients in multivariable analysis (p = 0.021). The N‐ and M‐classifications also had obvious prognostic effect but were not statistically significant by multivariate analysis due to the limited metastasis events. Three novel staging schemes (AHR‐Ⅰ–Ⅲ models, different combination of T‐ and N‐classifications) and ST (solely derived from Stell’s T‐classification) were developed, among which the AHR‐Ⅰ staging scheme performed best. Conclusions Tumor extension, quantified by Stell’s T‐classification, is the most significant prognostic factor for MESCC patients. However, our AHR‐Ⅰ staging scheme, a comprehensive staging scheme that integrating T‐, N‐, and M‐classifications, might be an optimal option for clinical practitioners to predict MESCC patients’ prognosis and make proper clinical decisions.
format	article
author	Ke Qiu Wendu Pang Jianqing Qiu Junhong Li Danni Cheng Yufang Rao Yijun Dong Minzi Mao Qiurui Liu Xiaosong Mu Wei Zhang Wei Xu Jianjun Ren Yu Zhao
author_facet	Ke Qiu Wendu Pang Jianqing Qiu Junhong Li Danni Cheng Yufang Rao Yijun Dong Minzi Mao Qiurui Liu Xiaosong Mu Wei Zhang Wei Xu Jianjun Ren Yu Zhao
author_sort	Ke Qiu
title	Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
title_short	Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
title_full	Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
title_fullStr	Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
title_full_unstemmed	Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma
title_sort	evaluating the prognostic contributions of tnm classifications and building novel staging schemes for middle ear squamous cell carcinoma
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/194a421b81544441af5b856a0d5ec38b
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Evaluating the prognostic contributions of TNM classifications and building novel staging schemes for middle ear squamous cell carcinoma

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