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.

中文翻译：

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比较美国癌症分期联合委员会分期系统的第八版和第七版以及皮肤鳞状细胞癌的布莱根妇女医院替代分期系统：对临床实践的意义

背景

美国第八届癌症分期联合委员会分期系统（AJCC-8）合并了有关皮肤鳞状细胞癌（CSCC）的变更。

目标

我们旨在将AJCC-8分期系统与先前的AJCC分期系统（AJCC-7）和布里格姆妇女医院（BWH）替代分期系统的第七版进行比较，以确定其在定义风险方面的用处和风险因素的用途CSCC中的预后组。

方法

回顾性收集了186例头部和颈部CSCC。从他们预测不良预后的能力的角度对所有3个分期系统进行了比较。建立二元逻辑回归模型来确定哪些风险因素最相关。

结果

预后不良主要与AJCC-7的T2期，BWH系统的T2b / T3期以及AJCC-8的T3期有关。AJCC-8和BWH分期系统在预测不良预后方面相互重叠，并且均优于AJCC-7。纳入AJCC-8的新危险因素和分化程度差与不良结局独立相关。

局限性

回顾性研究，很少有骨浸润病例。

结论

AJCC-8比AJCC-7更具特色，单调且同质，并且在肿瘤分层中与BWH系统有一些重叠。