Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

Comparing the 7th and 8th Editions of the American Joint Committee on Cancer Staging System for Hypopharyngeal Cancer Undergoing Surgery

Sunday, September 29, 2024
1:30 PM – 1:36 PM EDT
Location: MBCC, 208
Disclosure(s):
Heng-Yu Lin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Pen-Yuan Chu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The prognostic accuracy of the AJCC 8th staging system for hypopharyngeal squamous cell carcinoma has yet to be determined. This study aims to estimate the precision of survival prediction using the AJCC 8th edition, considering changes in the nodal staging classification, and compare its performance to that of the 7th edition.

Methods: A clinico-pathologically well-annotated cohort of 200 patients with hypopharyngeal squamous cell carcinoma from a prospective database who underwent surgical intervention as primary treatment at a tertiary referral center in Taiwan between 2007 to 2019 was analyzed. Overall survival (OS), disease-specific survival (DSS) and distant metastasis-free survival (DMFS) between stages of each AJCC edition were investigated using the Kaplan-Meier curve and log-rank test. Akaike information criterion (AIC) was further implemented to determine the performance regarding prognostic prediction of each AJCC edition.

Results: The median follow-up of the study cohort was 63.5 months (22.5-106 months). 93.5% of the patients (N=187) underwent at least one side of neck dissection. 40.5% of patients (N=81) were upstaged as per the AJCC 8th classification, all resulting from the redistribution of N stage. The survival curves for DSS and DMFS indicated a better separation of stage I, II, and IVb for the AJCC 8th edition compared to the 7th, yet an overlap was observed between stage III and IVa. The combination of extranodal extension (ENE) and level of cervical metastasis distinguished the survival curves for OS, DSS and DMFS well. The AJCC 8th system outperformed the 7th regarding the prognostic model performance, with a lower AIC for both OS (1065.0 versus 1069.4) and DSS (548.5 versus 560.5).

Conclusions: Compared to the AJCC 7th staging system, the 8th edition demonstrated a better efficacy for survival prediction in hypopharyngeal cancer, with its introduction of ENE status and revision on classification of nodal metastasis.

    Presenting Author(s)

  • Heng-Yu Lin, MD

    Resident
    Taipei Veterans General Hospital
    Taipei City, Taipei, Taiwan (Republic of China)

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Pen-Yuan Chu, MD

    Chairman
    Department of Otolaryngology-Head & Neck Surgery, Taiwan Veterans General Hospital
    Taipei, Taipei, Taiwan (Republic of China)

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.