Evaluation of the "new" TNM classification of head and neck tumors in 3247patients

The 5th edition of the TNM classification entails a number of changes conce rning head and necktumors. The division of stage IV tumors into three subca tegories marks a significant expansion of the stage grouping procedure. Met hods:ln a retrospective study the clinical course of 3247 patients with hea d and neck carcinomas were comparatively evaluated according to the 4th and 5th editions of the new TNM classification. In particular it was the aim o f the study to test the prognostic relevance of the subdivision of stage IV especially in mucosal cancer. Results:In classifying the primary tumor the most extensive changes were noted for supraglottic and salivary gland tumo rs. On the basis of the 4th edition of the TNM classification the following recurrence-free 5-year survival rates for 3033 cases of mucosal cancer wer e calculated: stage I 91,0%, stage II 78,6%, stage III 61,4%, stage IV 31,0 %. The calculations based on the 5th edition yielded:stage I 91,0%, stage I I 77,2%, stage nl 61,2%, stage IVA 32,4%, stage IVB 25,3%, stage IVC 3,6%. Conclusions:The adequacy of the revised stage classification in establishin g a prognostic hierarchy was confirmed. However,a significant prognostic di stinction between N2- (stage IVA) and N3-metastasis (stage IVB) could not b e found.