CLINICAL STAGING AND OPERATIVE REPORTING FOR MULTIINSTITUTIONAL TRIALS IN HEAD AND NECK SQUAMOUS-CELL CARCINOMA

Background. A Strategic Planning Conference (jointly supported by NCI and NIDCD) was convened to consider potential improvements in surgical patient data for multiinstitutional trials. The thesis underlying thi s project is that inadequacies in staging, pretreatment patient strati fication, and the details of surgical resection may have obscured the detection of treatment effect. The goals of this project were multiple : (1) to consider the utility of new clinical stratification variables , (2) to increase the precision of tumor staging, and (3) to improve o perative reporting for multi-institutional trials in head and neck can cer. Conclusions. The conference attendees came to a number of importa nt conclusions: (1) TNM status is inadequate for describing head and n eck cancer in a multi-institutional trial setting. A detailed anatomic reporting scheme is proposed; (2) comorbidity measures should be incl uded as patient descriptors, especially those that meet the criteria ' 'definitely important and easy to obtain''; (3) surgical reporting in multi-institutional trials should use a format that is compatible with computer analysis and use the same items as the revised (anatomic) st aging system; (4) the surgeon should be personally responsible for dat a coding and should interact directly with the pathologist in marking the surgical specimen; (5) pathologic reporting should use an anatomic template identical to the staging and operative reporting formats. (C ) 1997 John Wiley & Sons, Inc.