A Comparison of Fifth-Edition and Sixth-Edition American Joint Committee Staging System for Sinonasal Squamous Cell Carcinoma

Hur, Dong Gu; Rhee, Chae Seo; Kim, In Sang; Mo, Ji Hun; Lee, Chul Hee; Min, Yang Gi

Abstract

The American Joint Committee on Cancer staging system has been widely used for sinonasal cancer. The sixth-edition staging system suggests a new classification for staging sinonasal cancer. The purpose of this study was to evaluate the validity of 6th edition of AJCC (American Joint Committee on Cancer) staging system for predicting prognosis of sinonasal squamous cell cancer comparing with 5th edition. Sixty five sinonasal squamous cell cancer patients from 1981 through 2003 at SNUH were evaluated. Survival rates of different stages were analyzed using Kaplan-Meier method to determine mean, median, and 5-year survival statistics. The overall 5 year survival rate was 54%. The cases that changed stages from stage III (5th) to Iva (6th) showed a worse survival rate than the cases remained as stage III, although statistically insignificant. The survival rates of stage Iva (6th) and Ivb (6th) showed a significant difference (p=0.01). The stage III group evaluated by 5th edition changed into stage III or stage IVA in 6th edition and they showed different 5-year survival rates, 58% in stage III (6th) and 34% in stage IVA (6th)(p=0.248), and different local recurrence rates, 33.3% in stage III (6th) and 46.7% in stage IVA (6th) which might have resulted in a worse survival rate. The new 6th edition AJCC staging system seems to be better to predict the prognosis of sinonasal squamous carcinoma.