title: TNM staging compared with a new clinicopathological model in predicting oral tongue squamous cell carcinoma survival.
abstract: BACKGROUND
  The purpose of this study was to investigate the prognostic impact of comorbidity and of demographic and pathological factors on oral tongue squamous cell carcinoma (SCC) survival, and to compare the prognostic performance of a new clinicopathological model against the routinely used TNM staging.
  
  
  METHODS
  We conducted a retrospective study of demographic, clinical, and pathological information of 166 patients with oral tongue SCC. Cox regression was used for multivariate analysis, model building, and model discriminatory analysis.
  
  
  RESULTS
  Comorbidity had the most significant impact on overall survival (OS; log-rank test, chi-square  =  36.34; p  <  .0001). Comorbidity, tumor dimension >2 cm, and presence of extracapsular spread (ECS) or vascular invasion were independent predictors of survival. A clinicopathological model based on these 4 variables (chi-square  =  60.23; p  <  .0001) was better (c-statistic  =  0.736) at predicting survival compared to pathological TNM staging (c-statistic = 0.645).
  
  
  CONCLUSIONS
  Comorbidity combined with tumor dimension, ECS, and vascular invasion provide a better prediction of oral tongue SCC survival than TNM staging alone.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Oluwafunmilola T
authors.initials: OT
authors.lastname: Okuyemi
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Edward
authors.initials: E
authors.lastname: Spitznagel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: TNM staging; comorbidity; squamous cell carcinoma; survival; tongue cancer