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Comparative study between two different staging systems (AJCC TNM VS BALLANTYNE'S) for mucosal melanomas of the Head & Neck.

Luna-Ortiz K, Aguilar-Romero M, Villavicencio-Valencia V, Zepeda-Castilla E, Vidrio-Morgado H, Peteuil N, Mosqueda-Taylor A - Med Oral Patol Oral Cir Bucal (2016)

Bottom Line: An up-staging migration effect from Ballantyne's localized disease to moderate-ly and very advanced disease according to AJCC staging system.For locoregional disease the 5-year DFS / OS were 5% / 10% for Ballantyne's system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively.In this series, the TNM staging system for MM of the H&N predicted the prognosis of the disease when comparing with Ballantyne's system.

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, Av. San Fernando # 22 Col. Seccion XVI,Tlalpan, Mexico D.F. 14080, kuauhyama@yahoo.com.mx.

ABSTRACT

Background: Mucosal melanoma (MM) of head and neck (H&N) is a rare entity with a quite poor prognosis. Ballantyne's staging system has been commonly used since 1970. In the 7th edition of the AJCC Staging Manual a new chapter for the staging of TNM Classification system for mucosal melanoma (MM) of the head and neck (H&N) has been introduced to reflect the particularly aggressive biological behavior of this neoplasm. The aim of this study was to analyze and compare among Ballantyne's staging system vs TNM H&N in terms of overall survival (OS) and disease-free survival (DFS) in a consecutive population of patients with MM in a cancer centre.

Material and methods: Descriptive analysis of demographic, clinical and pathological variables of MM of the Head & Neck were performed. We compared the survival curves for both systems according to the Kaplan-Meier method using the Log-rank test.

Results: An up-staging migration effect from Ballantyne's localized disease to moderate-ly and very advanced disease according to AJCC staging system. The 5-year DFS and OS for Ballantyne's Localized Disease and AJCC Stage III were 31% and 36% vs. 47% and 50%, respectively. For locoregional disease the 5-year DFS / OS were 5% / 10% for Ballantyne's system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively.

Conclusions: In this series, the TNM staging system for MM of the H&N predicted the prognosis of the disease when comparing with Ballantyne's system.

No MeSH data available.


Related in: MedlinePlus

Disease-free survival (DFS) according to Ballantyne’s staging system (Kaplan-Meier).
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Figure 1: Disease-free survival (DFS) according to Ballantyne’s staging system (Kaplan-Meier).

Mentions: We identified sixty-six patients (n=66), 38 females (57.6%) and 28 males (42.4%), with a small predominance of the women (female:male ratio; 1.35:1) and a mean age of 55.39 years (range, 28 to 93 y). Fifty-six patients (84.8%) presented to the hospital because of local symptoms. The mean time between the appearance of the first symptoms and the time of presentation to the hospital was 9.64 months (range 1 to 60 months). Forty-one patients (62.1%) have been previously diagnosed or received any treatment before presenting to this cancer referral centre. Mean size of the primary tumour was 5.1 cm (range, 1 to 11 cm). Demographic and clinical variables as well as comparison between both staging systems (Ballantyne’s vs. AJCC) are shown in Table 1, demonstrating an upstaging migration effect from Ballantyne’s Local stage to TNM Stage IVA, and at the same time, a reduction in TNM Stage III to 15%. Therefore, there is an increment in Regional disease from Ballantyne’s 42.4% to 66.7% in TNM Stages IVA & IVB (an addition of 24.3%). Metastatic disease remains equal in both classifications. When computing disease-free survival (DFS) for Ballantyne’s Localized Disease we obtained a 5-year rate of 31% in comparison to the 47% observed for AJCC Stage III. In addition, it was calculated for locoregional disease a 5-year DFS of 5% for Ballantyne’s system vs. 13.8 and 0% for AJCC Stages IVA and IVB, respectively (Figs. 1,2).


Comparative study between two different staging systems (AJCC TNM VS BALLANTYNE'S) for mucosal melanomas of the Head & Neck.

Luna-Ortiz K, Aguilar-Romero M, Villavicencio-Valencia V, Zepeda-Castilla E, Vidrio-Morgado H, Peteuil N, Mosqueda-Taylor A - Med Oral Patol Oral Cir Bucal (2016)

Disease-free survival (DFS) according to Ballantyne’s staging system (Kaplan-Meier).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920455&req=5

Figure 1: Disease-free survival (DFS) according to Ballantyne’s staging system (Kaplan-Meier).
Mentions: We identified sixty-six patients (n=66), 38 females (57.6%) and 28 males (42.4%), with a small predominance of the women (female:male ratio; 1.35:1) and a mean age of 55.39 years (range, 28 to 93 y). Fifty-six patients (84.8%) presented to the hospital because of local symptoms. The mean time between the appearance of the first symptoms and the time of presentation to the hospital was 9.64 months (range 1 to 60 months). Forty-one patients (62.1%) have been previously diagnosed or received any treatment before presenting to this cancer referral centre. Mean size of the primary tumour was 5.1 cm (range, 1 to 11 cm). Demographic and clinical variables as well as comparison between both staging systems (Ballantyne’s vs. AJCC) are shown in Table 1, demonstrating an upstaging migration effect from Ballantyne’s Local stage to TNM Stage IVA, and at the same time, a reduction in TNM Stage III to 15%. Therefore, there is an increment in Regional disease from Ballantyne’s 42.4% to 66.7% in TNM Stages IVA & IVB (an addition of 24.3%). Metastatic disease remains equal in both classifications. When computing disease-free survival (DFS) for Ballantyne’s Localized Disease we obtained a 5-year rate of 31% in comparison to the 47% observed for AJCC Stage III. In addition, it was calculated for locoregional disease a 5-year DFS of 5% for Ballantyne’s system vs. 13.8 and 0% for AJCC Stages IVA and IVB, respectively (Figs. 1,2).

Bottom Line: An up-staging migration effect from Ballantyne's localized disease to moderate-ly and very advanced disease according to AJCC staging system.For locoregional disease the 5-year DFS / OS were 5% / 10% for Ballantyne's system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively.In this series, the TNM staging system for MM of the H&N predicted the prognosis of the disease when comparing with Ballantyne's system.

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, Av. San Fernando # 22 Col. Seccion XVI,Tlalpan, Mexico D.F. 14080, kuauhyama@yahoo.com.mx.

ABSTRACT

Background: Mucosal melanoma (MM) of head and neck (H&N) is a rare entity with a quite poor prognosis. Ballantyne's staging system has been commonly used since 1970. In the 7th edition of the AJCC Staging Manual a new chapter for the staging of TNM Classification system for mucosal melanoma (MM) of the head and neck (H&N) has been introduced to reflect the particularly aggressive biological behavior of this neoplasm. The aim of this study was to analyze and compare among Ballantyne's staging system vs TNM H&N in terms of overall survival (OS) and disease-free survival (DFS) in a consecutive population of patients with MM in a cancer centre.

Material and methods: Descriptive analysis of demographic, clinical and pathological variables of MM of the Head & Neck were performed. We compared the survival curves for both systems according to the Kaplan-Meier method using the Log-rank test.

Results: An up-staging migration effect from Ballantyne's localized disease to moderate-ly and very advanced disease according to AJCC staging system. The 5-year DFS and OS for Ballantyne's Localized Disease and AJCC Stage III were 31% and 36% vs. 47% and 50%, respectively. For locoregional disease the 5-year DFS / OS were 5% / 10% for Ballantyne's system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively.

Conclusions: In this series, the TNM staging system for MM of the H&N predicted the prognosis of the disease when comparing with Ballantyne's system.

No MeSH data available.


Related in: MedlinePlus