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Comparing Staging Systems in Cutaneous Squamous Cell Carcinoma

By: Hillary Ojeda
Posted: Wednesday, February 27, 2019

According to a study published in Dermatologic SurgeryBrigham and Women’s Hospital (BWH) and the American Joint Committee on Cancer eighth edition (AJCC-8) staging systems stratify cutaneous squamous cell carcinoma similarly for immunosuppressed patients. Adam B. Blechman, MD, of the Hunterdon Center for Dermatology, New Jersey, and colleagues, concluded that distinctiveness, homogeneity, and monotonicity were alike in each system.

“This is the first study to validate the AJCC-8 staging system and compare it with the BWH system in a solely immunosuppressed population,” the investigators commented. “It is also one of the largest studies to evaluate cutaneous squamous cell carcinoma prognosis in the immunosuppressed population.”

This retrospective study enrolled 58 immunosuppressed patients diagnosed with primary squamous cell carcinoma from 2012 to 2016. With AJCC-8 staging, half of the tumors were T1; 44.7% were T2, and 4.8% were T3. With BWH staging, half of the tumors were T1, 48.5% were T2a, 1.3% were T2b, and 0.4% were T3. The risk of poor outcomes with the committee staging system was 1.7%, 8.8%, and 36.4% for T1, T2, and T3, respectively (P < .01), whereas the risk with the BWH system was 1.8%, 9.9%, 33.3%, and 100.0% for T1, T2a, T2b, and T3, respectively (P < .01).

Of the AJCC group, 36% of patients with T3 or T4 tumors had poor outcomes compared with 5.1% of patients with a low T1 or T2 stage (P = .002). A total of 50% of patients with T2b or T3 tumors on BWH staging had poor outcomes compared with 5.3% of patients with a low T1 or T2a stage (P = .01).

Disclosure: The study authors reported no conflicts of interest.



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