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Ardalan Ebrahimi, Ziv Gil, Moran Amit, Tzu-Chen Yen, Chun-Ta Liao, Pankaj Chaturvedi, Jai Prakash Agarwal, Luiz P. Kowalski, Hugo F. Kohler, Matthias Kreppel, Claudio R. Cernea, Jose Brandao, Gideon Bachar, Andrea Bolzoni Villaret, Dan Fliss, Eran Fridman, K. Thomas Robbins, Jatin P. Shah, Snehal G. Patel, Jonathan R. Clark and The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer. The prognosis of N2b and N2c lymph node disease in oral squamous cell carcinoma is determined by the number of metastatic lymph nodes rather than laterality: Evidence to support a revision of the American Joint Committee on Cancer staging system Cancer 120

Version of Record online: 1 APR 2014 | DOI: 10.1002/cncr.28686

This multicenter international study of 3704 patients with oral squamous cell carcinoma demonstrated significant heterogeneity in prognosis based on the number of metastatic lymph nodes (≤ 2, 3–4, and ≥ 5) in patients with both N2b and N2c lymph node disease. Furthermore, the prognoses of patients with N2b and N2c disease were similar after adequate adjustment for the burden of lymph node metastases, irrespective of laterality. Based on these results, the authors propose a modification of the American Joint Committee on Cancer lymph node staging system that is associated with a significant improvement in prognostic accuracy.

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