Estadiaje Carcinoma Epidermoide

Comparing Staging Systems for Cutaneous Squamous Cell Carcinoma

TAKE-HOME MESSAGE

• The authors of this retrospective study compared the 8th edition of the AJCC (AJCC-8) staging system with the 7th edition (AJCC-7) and the Brigham and Women's Hospital (BWH) staging system in terms of their ability to predict poor prognosis in cutaneous squamous cell carcinoma (CSCC). Both the AJCC-8 and the BWH's staging systems were superior to the AJCC-7 in predicting poor prognosis.

• The AJCC-8 staging system seems to be considerably superior to the AJCC-7 and showed overlap with the BWH's system. Further studies are needed to better refine T3 tumors in AJCC-8 and to build a staging system for CSCC that can be used to classify tumors beyond the head and neck.

  – InYoung Kim, MD, PhD

Abstract:

BACKGROUND

The new 8th edition of the American Joint Committee on Cancer (AJCC) staging system incorporates changes regarding cutaneous squamous cell carcinoma (CSCC).

OBJECTIVES

We aimed to compare the 8th edition of the AJCC (AJCC-8) staging system with the previous 7th edition (AJCC-7) and the Brigham and Women's Hospital 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 was retrospectively collected. All three staging systems were compared in 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 T2-AJCC-7, with T2b/T3-BWH's and with T3-AJCC-8. The AJCC-8 and the BWH's staging systems displayed overlap between each other 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 in the stratification of tumors with the BWH's system.

Journal of the American Academy of Dermatology

Comparing the Eighth and the Seventh Editions of the AJCC Staging System and the Brigham and Women's Hospital Alternative Staging System for Cutaneous Squamous Cell Carcinoma: Implications for Clinical Practice

J Am Acad Dermatol 2018 Jul 09;[EPub Ahead of Print], J Cañueto, J Burguillo, D Moyano-Bueno, A Viñolas-Cuadros, A Conde-Ferreirós, LA Corchete-Sánchez, J Pérez-Losada, C Román-Curto