title: Incorporation of log odds of positive lymph nodes into the AJCC TNM classification improves prediction of survival in oral cancer.
abstract: OBJECTIVE
  To assess the prognostic performance of a new N classification that incorporates the log odds of positive lymph nodes (LODDS) into the routinely used pathological N classification for oral squamous cell carcinoma (OSCC) patients.
  
  
  METHODS
  Retrospective cohort study utilising LODDS into pN category was performed, and the AJCC TNM stage and T-New N-M stage were compared with respect to 5-year disease-specific survival (DSS) rates. The discriminability was evaluated from the linear trend chi-square test, Akaike information criterion (AIC) and Harrell's c-statistic.
  
  
  METHODS
  Medical centrer in Taiwan.
  
  
  METHODS
  A total of 463 patients received primary surgery and neck dissection between 2004 and 2013 for OSCC.
  
  
  METHODS
  The discriminability for 5-year DSS rates.
  
  
  RESULTS
  The median follow-up period was 54 months, the mean patient age was 54 ± 11 years and 428 patients (92.4%) were male. The patients with higher LODDS had worse 5-year DSS rates. Incorporation of LODDS into the prognostic model based on the seventh edition of the TNM classification significantly improved discriminative performance for 5-year DSS with a lower AIC (1883 versus 1897), and higher prediction accuracy (Harrell's c-statistic: 0.768 versus 0.764).
  
  
  CONCLUSIONS
  By utilising a merger of the LODDS and pN classifications to create a new N classification has better discriminatory and predictive ability than pathological TNM staging and could help identify high-risk patients for intense adjuvant therapy.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Defense Medical Center, Taipei, Taiwan.|Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Defense Medical Center, Taipei, Taiwan.|Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Y-S
authors.initials: YS
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Defense Medical Center, Taipei, Taiwan.|Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: B-H
authors.initials: BH
authors.lastname: Kang
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Defense Medical Center, Taipei, Taiwan.|Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: K-P
authors.initials: KP
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Chi
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: M-Y
authors.initials: MY
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Su
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Defense Medical Center, Taipei, Taiwan.|Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: T-S
authors.initials: TS
authors.lastname: Chang
authors.affiliation: Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Pingtung Christian Hospital, Pingtung, Taiwan.
authors.forename: P-C
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: W-L
authors.initials: WL
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, E-Da Hospital, Kaohsiung, Taiwan.
authors.forename: C-I
authors.initials: CI
authors.lastname: Huang
authors.affiliation: Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: P
authors.initials: P
authors.lastname: Chou
authors.affiliation: Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan.|Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.|Department of Biotechnology, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Yang
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology