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

• Published in: Klinická onkologie Vol. 29; no. 2; p. 122
• Main Authors: Kordač, P, Kalfeřt, D, Smatanová, K, Laco, J, Vošmik, M, Čelakovský, P, Chrobok, V
• Format: Journal Article
• Language: Czech
• Published: Czech Republic 2016
• Subjects: Adult; Aged; Aged, 80 and over; Disease-Free Survival; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Oropharyngeal Neoplasms - mortality; Oropharyngeal Neoplasms - pathology; Prognosis
• ISSN: 0862-495X

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. 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. 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). 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.