Christian Mirian Larsen

TY - JOUR

T1 - Limits and potential implementation of the present pN classification for oral squamous cell carcinoma

AU - Mortensen, Jonas

AU - Mirian, Christian

AU - Ovesen, Therese

N1 - Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.

PY - 2022/4

Y1 - 2022/4

N2 - Purpose of reviewThe purpose of this review is to highlight the most important changes in the eighth TNM classification system for oral squamous cell carcinomas compared with the seventh edition with focus on lymph node staging (pN). Nodal involvement is crucial when addressing prediction of survival, and staging must mirror the disease extension. pN classification will be evaluated with respect to lymph node yield (LNY), lymph node density (LND), and a recently proposed classification: pN-N+ reflecting positive regional lymph nodes (metastatic burden) and extra nodal extension.Recent findingsTNM8 was introduced in 2018, and the most noteworthy changes were depth of invasion (DOI) and extranodal extension (ENE). Recent studies indicate, that TNM8-related pN is not superior to TNM7 with respect to predicting survival. LNY and LND are biased with ecological interference fallacy, and currently not recommended in future iterations of TNM. In contrast, the pN-N+classification has demonstrated improved survival prediction compared with TNM8.SummaryThe recent findings support the inclusion of pN-N+, that is, metastatic burden and extranodal extension in future iterations of TNM.

AB - Purpose of reviewThe purpose of this review is to highlight the most important changes in the eighth TNM classification system for oral squamous cell carcinomas compared with the seventh edition with focus on lymph node staging (pN). Nodal involvement is crucial when addressing prediction of survival, and staging must mirror the disease extension. pN classification will be evaluated with respect to lymph node yield (LNY), lymph node density (LND), and a recently proposed classification: pN-N+ reflecting positive regional lymph nodes (metastatic burden) and extra nodal extension.Recent findingsTNM8 was introduced in 2018, and the most noteworthy changes were depth of invasion (DOI) and extranodal extension (ENE). Recent studies indicate, that TNM8-related pN is not superior to TNM7 with respect to predicting survival. LNY and LND are biased with ecological interference fallacy, and currently not recommended in future iterations of TNM. In contrast, the pN-N+classification has demonstrated improved survival prediction compared with TNM8.SummaryThe recent findings support the inclusion of pN-N+, that is, metastatic burden and extranodal extension in future iterations of TNM.

KW - oral squamous cell carcinoma

KW - pN

KW - pN-N

KW - TNM7

KW - TNM8

UR - http://www.scopus.com/inward/record.url?scp=85125964355&partnerID=8YFLogxK

U2 - 10.1097/MOO.0000000000000788

DO - 10.1097/MOO.0000000000000788

M3 - Review

C2 - 34954722

AN - SCOPUS:85125964355

VL - 30

SP - 94

EP - 98

JO - Current Opinion in Otolaryngology and Head and Neck Surgery

JF - Current Opinion in Otolaryngology and Head and Neck Surgery

SN - 1068-9508

IS - 2

ER -