Prognostic value of the seventh AJCC/UICC TNM classification of intestinal-type ethmoid adenocarcinoma: Systematic review and risk prediction model

Head Neck. 2017 Apr;39(4):668-678. doi: 10.1002/hed.24663. Epub 2017 Jan 9.

Abstract

Background: The purpose of this study was to propose a prognostic classification of intestinal-type adenocarcinoma (ITAC) based on literature search and prognostic modeling of cohort data.

Methods: We first conducted a literature search to assess the homogeneity of the reported estimates of 5-year survival and to identify the influence of T classification. We then pooled prospective data from 3 large French and Italian series to predict time to all-cause mortality. The sample was randomly split to derive and then to validate the proposed prognostic model.

Results: Literature analysis confirmed the heterogeneity in 5-year survival rates, partly explained in subsets of homogeneous T-values. The sample included 223 patients, randomly separated into a derivation (n = 141) and a validation set (n = 82). Invasion of the sphenoid lateral and/or posterior walls and dura/cerebral invasion were systematically associated with a poor survival.

Conclusion: The incorporation of the invasion of the sphenoid lateral or posterior walls should be considered for ITAC management and prognostication. © 2017 Wiley Periodicals, Inc. Head Neck 39: 668-678, 2017.

Keywords: TNM classification; adenocarcinoma; endoscopic resection with transnasal craniectomy; ethmoid; intestinal-type adenocarcinoma (ITAC).

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Cause of Death*
  • Disease-Free Survival
  • Ethmoid Bone / pathology*
  • Female
  • Humans
  • Intestinal Neoplasms / mortality
  • Intestinal Neoplasms / pathology
  • Male
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Skull Neoplasms / mortality
  • Skull Neoplasms / pathology*
  • Survival Analysis