Clinical staging and operative reporting for multi-institutional trials in head and neck squamous cell carcinoma.
BACKGROUND
A Strategic Planning Conference (jointly supported by NCI and NIDCD) was convened to consider potential improvements in surgical patient data for multi-institutional trials. The thesis underlying this project is that inadequacies in staging, pretreatment patient stratification, and the details of surgical resection may have obscured the detection of treatment effect. The goals of this project were multiple: (1) to consider the utility of new clinical stratification variables, (2) to increase the precision of tumor staging, and (3) to improve operative reporting for multi-institutional trials in head and neck cancer.


CONCLUSIONS
The conference attendees came to a number of important conclusions: (1) TNM status is inadequate for describing head and neck cancer in a multi-institutional trial setting. A detailed anatomic reporting scheme is proposed; (2) comorbidity measures should be included as patient descriptors, especially those that meet the criteria "definitely important and easy to obtain"; (3) surgical reporting in multi-institutional trials should use a format that is compatible with computer analysis and use the same items as the revised (anatomic) staging system; (4) the surgeon should be personally responsible for data coding and should interact directly with the pathologist in marking the surgical specimen; (5) pathologic reporting should use an anatomic template identical to the staging and operative reporting formats.
Weymuller
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EA
Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle 98195, USA.
D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D003625:Data Collection / Q000379:methods / Q000592:standards; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D015337:Multicenter Studies as Topic / Q000592:standards; D009367:Neoplasm Staging