[Evaluation of the "new" TNM classification of head and neck tumors in 3247 patients].
The 5th edition of the TNM classification entails a number of changes concerning head and neck tumors. The division of stage IV tumors into three subcategories marks a significant expansion of the stage grouping procedure.


METHODS
In a retrospective study the clinical course of 3247 patients with head and neck carcinomas were comparatively evaluated according to the 4th and 5th editions of the new TNM classification. In particular it was the aim of the study to test the prognostic relevance of the subdivision of stage IV especially in mucosal cancer.


RESULTS
In classifying the primary tumor the most extensive changes were noted for supraglottic and salivary gland tumors. On the basis of the 4th edition of the TNM classification the following recurrence-free 5-year survival rates for 3033 cases of mucosal cancer were calculated: stage I 91,0%, stage II 78.6%, stage III 61.4%, stage IV 31.0%. The calculations based on the 5th edition yielded: stage I 91.0%, stage II 77.2%, stage III 61.2%, stage IVA 32.4%, stage IVB 25.3%, stage IVC 3.6%.


CONCLUSIONS
The adequacy of the revised stage classification in establishing a prognostic hierarchy was confirmed. However, a significant prognostic distinction between N2- (stage IVA) and N3-metastasis (stage IVB) could not be found.
Waldfahrer
F
F
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universität des Saarlandes, Homburg. HNOFWAL@MED-RZ.UNI-SB.DE
Maldea
L
L
Altendorf-Hofmann
A
A
Iro
H
H
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies
Evaluierung der neuen TNM-Stadieneinteilung für Kopf-Hals-Tumoren anhand von 3247 Patienten.