Javier Cañueto1, Javier Burguillo2, David Moyano-Bueno3, Alex Viñolas-Cuadros3, Alberto Conde-Ferreirós3, Luis Antonio Corchete-Sánchez4, Jesús Pérez-Losada5, Concepción Román-Curto6. 1. Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca, Hospital Universitario de Salamanca, Salamanca, Spain. Electronic address: jcanueto@usal.es. 2. Departamento de Química-Física, Facultad de Farmacia, Campus Miguel de Unamuno, Salamanca, Spain. 3. Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain. 4. Instituto de Investigación Biomédica de Salamanca, Hospital Universitario de Salamanca, Salamanca, Spain. 5. Instituto de Investigación Biomédica de Salamanca, Hospital Universitario de Salamanca, Salamanca, Spain; Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca/CSIC, Campus Miguel de Unamuno, Salamanca, Spain. 6. Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca, Hospital Universitario de Salamanca, Salamanca, Spain.
Abstract
BACKGROUND: The new eighth edition of the American Joint Committee on Cancer staging system (AJCC-8) incorporates changes regarding cutaneous squamous cell carcinoma (CSCC). OBJECTIVES: We aimed to compare the AJCC-8 staging system with the previous seventh edition of the AJCC staging system (AJCC-7) and the Brigham and Women's Hospital (BWH) alternative staging system to identify their usefulness and the utility of their risk factors in defining prognostic groups in CSCC. METHODS: A series of 186 CSCCs of the head and neck were retrospectively collected. All 3 staging systems were compared from the standpoint of their ability to predict poor prognosis. Binary logistic regression models were built to determine which risk factors were most relevant. RESULTS: Poor prognosis was mainly associated with stage T2 of the AJCC-7, with stages T2b/T3 of the BWH system, and with stage T3 of the AJCC-8. The AJCC-8 and the BWH staging systems displayed overlap with each another in predicting poor prognosis, and both were superior to the AJCC-7. The new risk factors incorporated into the AJCC-8 and the poor degree of differentiation were independently associated with poor outcome. LIMITATIONS: Retrospective study and few cases with bone invasion. CONCLUSIONS: The AJCC-8 is more distinctive, monotonous, and homogeneous than the AJCC-7 and shows some overlap with the BWH system in stratification of tumors.
BACKGROUND: The new eighth edition of the American Joint Committee on Cancer staging system (AJCC-8) incorporates changes regarding cutaneous squamous cell carcinoma (CSCC). OBJECTIVES: We aimed to compare the AJCC-8 staging system with the previous seventh edition of the AJCC staging system (AJCC-7) and the Brigham and Women's Hospital (BWH) alternative staging system to identify their usefulness and the utility of their risk factors in defining prognostic groups in CSCC. METHODS: A series of 186 CSCCs of the head and neck were retrospectively collected. All 3 staging systems were compared from the standpoint of their ability to predict poor prognosis. Binary logistic regression models were built to determine which risk factors were most relevant. RESULTS: Poor prognosis was mainly associated with stage T2 of the AJCC-7, with stages T2b/T3 of the BWH system, and with stage T3 of the AJCC-8. The AJCC-8 and the BWH staging systems displayed overlap with each another in predicting poor prognosis, and both were superior to the AJCC-7. The new risk factors incorporated into the AJCC-8 and the poor degree of differentiation were independently associated with poor outcome. LIMITATIONS: Retrospective study and few cases with bone invasion. CONCLUSIONS: The AJCC-8 is more distinctive, monotonous, and homogeneous than the AJCC-7 and shows some overlap with the BWH system in stratification of tumors.
Keywords:
AJCC; American Joint Committee on Cancer; Brigham and Women's Hospital; cutaneous squamous cell carcinoma; poor degree of differentiation; prognosis; skin cancer staging
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