TNM-based stage groupings in head and neck cancer: application in cancer of the hypopharynx.
BACKGROUND
The purpose of this study was to test the Union Internationale Contre le Cancer (UICC)/TNM category-based head and neck cancer stage grouping systems proposed in the literature for their ability to create clinically relevant prognostic groups of like-patients with cancer of the hypopharynx.


METHODS
Population-based retrospective survival study of 595 patients with squamous cell carcinoma of the hypopharynx across Ontario, Canada, from January 1990 to January 2000. The grouping systems of UICC/TNM, T and N Integer Score (TANIS), Hart, Berg, Snyderman, Kiricuta, and Hall were tested and compared for prognostic ability using hazard consistency, hazard discrimination, percent variance explained, outcome prediction, and balance.


RESULTS
All 8 systems predicted disease-specific survival. The system proposed by Snyderman performed the best, and UICC/TNM sixth edition did not perform as well as most.


CONCLUSIONS
The UICC/TNM stage group classification, although successful in creating statistically distinct groups, did not perform as well as other stage grouping systems, continuing a theme that has been reported previously.
Hall
Stephen F
SF
Department of Otolaryngology, Queen's University, Kingston, Ontario, Canada. sfh@queensu.ca
Groome
Patti A
PA
Irish
Jonathan
J
O'Sullivan
Brian
B
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000145:classification* / Q000401:mortality / Q000473:pathology; D002423:Cause of Death; D005260:Female; D006258:Head and Neck Neoplasms / Q000145:classification / Q000473:pathology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000145:classification; D011379:Prognosis