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Abstract：
American Joint Committee for Cancer (AJCC) staging manual has been recently updated with 8th edition which led to an immense shift in the tumor, node, and composite stages, in comparison to the previous staging. This was mainly due to the incorporation of depth of invasion (DOI) and extranodal extension (ENE) in staging. The impact of new staging system is widely studied as combined subsites in oral cancer. This study is to focus on a single subsite of oral cavity which is known for its poor prognosis. We evaluated 109 patients who had buccal mucosal squamous cell carcinomas (BSCC) who underwent treatment, with a curative intend, between 2014 and 2015. Clinical records were reviewed and the tumors were re-staged as per 8th edition of AJCC; disease-free survival (DFS) was also analyzed. Our study population had a mean age of 54.5 ± 10.35 years and male to female ratio of 4:1. During a median follow-up of 41 months, 35 patients (32.1%) developed recurrence. There was a statistically significant shift in stages between AJCC 7th edition against AJCC 8th edition leading to 34% upshift in T-stage, 43.1% upshift in N-stage, eventually leading to a 23.9% upshift in the composite stage. Tumors which got upgraded due to upshift in nodal stage had a poor survival (p = 0.002). Newer staging system is easy to use in clinical practice. Around a quarter of the BSCC got upstaged with the introduction of the newer staging system. But it was surprising to note that there were no statistically significant differences in DFS between the tumors of the same composite stages with regard to the two staging systems.
摘要：
美国癌症联合委员会（AJCC）分期手册最近已更新为第8版，这导致了肿瘤的巨大转变，节点,和复合阶段，与前一个阶段相比。这主要是由于分期中包含了侵入深度（DOI）和结外延伸（ENE）。新分期系统的影响作为组合亚位点在口腔癌中被广泛研究。这项研究的重点是以预后不良而闻名的口腔单个亚位点。我们评估了109例接受治疗的颊粘膜鳞状细胞癌（BSCC）患者，有治愈的意图，2014年至2015年。根据AJCC第8版审查了临床记录，并对肿瘤进行了重新分期；还分析了无病生存期（DFS）。我们的研究人群的平均年龄为54.5±10.35岁，男女比例为4：1。在41个月的中位随访中，35例患者（32.1%）复发。AJCC第7版与AJCC第8版之间的阶段差异有统计学意义，导致T阶段升档34％，N级升档43.1%,最终导致复合阶段23.9%的升档。由于结节期的升移而升级的肿瘤具有较差的存活率(p=0.002)。较新的分期系统易于在临床实践中使用。由于引入了较新的分期系统，大约四分之一的BSCC被赶超。但是令人惊讶地注意到,关于两个分期系统,相同复合分期的肿瘤之间的DFS没有统计学上的显著差异。
