The impact of clinical versus pathological staging in oral cavity carcinoma–a multi-institutional analysis of survival

Abstract

Abstract Objectives To evaluate any disparity in clinical versus pathological TNM staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of this on survival. Design Demographic, survival, staging, and pathologic data on all patients undergoing surgical treatment for OCSCC in Alberta between 1998 and 2006 was collected. Clinical and pathological TNM staging data were compared. Patients were stratified as pathologically downstaged, upstaged or unchanged. Setting Tertiary care centers in Alberta, Canada. Main outcome measures Survival differences between groups were analyzed using Kaplan-Meier and Cox regression models. Results Patients with clinically early stage tumors were pathologically upstaged in 21.9% of cases and unchanged in 78.1% of cases. Patients with clinically advanced stage tumors were pathologically downstaged in 7.9% of cases and unchanged in 92.1% of cases. Univariate and multivariate estimates of disease-specific survival showed no statistically significant differences in survival when patients were either upstaged or downstaged. Conclusions Some disparity exists in clinical versus pathological staging in OCSCC, however, this does not have any significant impact on disease specific survival.