Operational classification of cutaneous squamous cell carcinomas based on unsupervised clustering of real cases by experts

被引：1

作者：

Gaudy-Marqueste, C. ^{[1
]}

Grob, J. J. ^{[1
]}

Garbe, C. ^{[2
]}

Ascierto, P. A. ^{[3
]}

Arron, S. ^{[4
,25
]}

Basset-Seguin, N. ^{[5
]}

Bohne, A. S. ^{[6
]}

Lenoir, C. ^{[7
]}

Dummer, R. ^{[8
]}

Fargnoli, M. C. ^{[9
]}

Guminski, A. ^{[10
,11
]}

Hauschild, A. ^{[6
]}

Kaufmann, R. ^{[12
]}

Lallas, A. ^{[13
]}

del Marmol, V. ^{[14
]}

Migden, M. ^{[15
,16
]}

Penicaud, M. ^{[17
]}

Rembielak, A. ^{[18
,19
]}

Stratigos, A. ^{[20
]}

Tagliaferri, L. ^{[21
,22
]}

Zalaudek, I. ^{[23
]}

Arance, A. ^{[24
]}

Badinand, D. ^{[26
]}

Bossi, P. ^{[27
,28
]}

Challapalli, A. ^{[29
]}

Clementi, M. ^{[30
]}

Di Stefani, A. ^{[31
,32
]}

Ferrandiz-Pulido, C. ^{[33
,34
]}

Giuffrida, R. ^{[35
]}

Gravina, G. L. ^{[36
]}

Ha, P. ^{[37
]}

Heinzerling, L. ^{[38
]}

Mallet, S. ^{[1
]}

Paradisi, A. ^{[31
,32
]}

Mohr, P. ^{[39
]}

Piccerillo, A. ^{[31
,32
]}

Rutkowski, D. ^{[40
]}

Saiag, P. ^{[41
,42
]}

Sollena, P. ^{[31
,32
]}

Trakatelli, M. ^{[43
]}

Wojcieszek, P. ^{[44
]}

Yom, S. S. ^{[45
]}

Zelin, E. ^{[46
]}

Peris, K. ^{[31
,32
]}

Malvehy, J. ^{[47
,48
]}

机构：

[1] Aix Marseille Univ, APHM, Dermatol & Skin Canc Dept, Marseille, France

[2] Eberhard Karls Univ Tubingen, Ctr Dermatooncol, Dept Dermatol, Tubingen, Germany

[3] Ist Nazl Tumori IRCCS Fdn Pascale, Dept Skin Canc Canc Immunotherapy & Dev Therapeut, Naples, Italy

[4] Peninsula Dermatol, Burlingame, CA USA

[5] St Louis Hosp, Dermatol Dept, Paris, France

[6] Univ Hosp Schleswig Holstein UKSH, Dept Dermatol, Campus Kiel, Kiel, Germany

[7] Univ Libre Bruxelles, Hop Univ Bruxelles, Dept Dermatol, Brussels, Belgium

[8] Univ Hosp Zurich, Skin Canc Ctr, Zurich, Switzerland

[9] Univ LAquila, Dept Biotechnol & Appl Clin Sci, Dermatol, Laquila, Italy

[10] Royan North Shore Hosp, Dept Med Oncol, Sydney, NSW, Australia

[11] Univ Sydney, Northern Clin Sch, Sydney, NSW, Australia

[12] Frankfurt Univ Hosp, Dept Dermatol Venereol & Allergol, Frankfurt, Germany

[13] Aristotle Univ Thessaloniki, Fac Hlth Sci, Sch Med, Dept Dermatol 1, Thessaloniki, Greece

[14] Univ Libre Bruxelles, Univ Erasme Hosp, Dept Dermatol, Brussels, Belgium

[15] UT MD Anderson Canc Ctr, Dept Dermatol, Houston, TX USA

[16] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA

[17] La Conception Univ Hosp, Dept Oto Rhino Laryngol & Head & Neck Surg, APHM, Marseille, France

[18] Christie NHS Fdn Trust, Dept Clin Oncol, Manchester, England

[19] Univ Manchester, Fac Biol, Sch Med Sci, Div Canc Sci, Manchester, England

[20] Natl & Kapodistrian Univ Athens, Andreas Sygros Hosp, Dept Dermatol Venereol 1, Athens, Greece

[21] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Diagnost Immagini & Radioterapia Onco, Rome, Italy

[22] Univ Cattolica Sacro Cuore, Rome, Italy

[23] Univ Trieste, Maggiore Hosp, Dermatol Clin, Trieste, Italy

[24] Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain

[25] Hosp Clin Barcelona, IDIBAPS, Barcelona, Spain

[26] Hosp La Timone, Dept Radiotherapy Oncol, Marseille, France

[27] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[28] IRCCS Humanitas Res Hosp, Milan, Italy

[29] UHBW, Bristol Haematol & Oncol Ctr, Dept Oncol, Bristol, England

[30] Univ LAquila, Dept Biotechnol & Appl Clin Sci, Laquila, Italy

[31] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Med & Chirurg Addominali & Endocr, UOC Dermatol, Rome, Italy

[32] Univ Cattolica Sacro Cuore, Dipartimento Med & Chirurg Traslazionale, Dermatol, Rome, Italy

[33] Univ Hosp Vall dHebron, Dept Dermatol, Barcelona, Spain

[34] Univ Autonoma Barcelona, Fac Med, Bellaterra, Spain

[35] Univ Messina, Dept Clin & Expt Med, Dermatol, Messina, Italy

[36] Univ LAquila, Dept Biotechnol & Appl Clin Sci, Radiotherapy & Radiobiol Unit, Laquila, Italy

[37] Univ Calif San Francisco, Dept Otolaryngol Head & Neck Surg, San Francisco, CA USA

[38] Ludwig Maximilian Univ Hosp, LMU, Dept Dermatol & Allergy, Munich, Germany

[39] Elbe Kliniken Buxtehude, Dept Dermatol, Buxtehude, Germany

[40] Manchester Fdn Trust, Dept Dermatol, Manchester, England

[41] Univ Paris Saclay, Ambroise Pare Hosp, APHP, Dept Gen & Oncol Dermatol, Boulogne Billancourt, France

[42] Univ Paris Saclay, EA Biomarkers Cancerol & Hemato Oncol 4340, UVSQ, Boulogne Billancourt, France

[43] Aristotle Univ Thessaloniki, Papageorgiou Gen Hosp, Sch Med, Dept Dermatol 2, Thessaloniki, Greece

[44] Mar Sklodowska Curie Natl Res Inst Oncol MSCNRIO, Brachytherapy Dept, Gliwice, Poland

[45] Univ Calif San Francisco, Dept Radiat Oncol, San Francisco, CA USA

[46] St Maria Misericordia Univ Hosp, Inst Dermatol, Udine, Italy

[47] Univ Barcelona, Hosp Clin Barcelona, Dermatol Dept, IDIBAPS, Barcelona, Anguilla

[48] ICIII, CIBER enfermedades Raras, Barcelona, Spain

来源：

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY | 2025年 / 39卷 / 03期

关键词：

AMERICAN JOINT COMMITTEE; CANCER;

D O I：

10.1111/jdv.20209

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

BackgroundThere is currently no staging system for cutaneous squamous cell carcinoma (cSCC) that is adapted to decision-making and universally used. Experts have unconscious ability to simplify the heterogeneity of clinical situations into a few relevant groups to drive their therapeutic decisions. Therefore, we have used unsupervised clustering of real cases by experts to generate an operational classification of cSCCs, an approach that was successful for basal cell carcinomas.ObjectiveTo generate a consensual and operational classification of cSCCs.MethodUnsupervised independent clustering of 248 cases of cSCCs considered difficult-to-treat. Eighteen international experts from different specialties classified these cases into what they considered homogeneous clusters useful for management, each with freedom regarding clustering criteria. Convergences and divergences between clustering were analysed using a similarity matrix, the K-mean approach and the average silhouette method. Mathematical modelling was used to look for the best consensual clustering. The operability of the derived classification was validated on 23 new practitioners.ResultsDespite the high heterogeneity of the clinical cases, a mathematical consensus was observed. It was best represented by a partition into five clusters, which appeared a posteriori to describe different clinical scenarios. Applicability of this classification was shown by a good concordance (94%) in the allocation of cases between the new practitioners and the 18 experts. An additional group of easy-to-treat cSCC was included, resulting in a six-group final classification: easy-to-treat/complex to treat due to tumour and/or patient characteristics/multiple/locally advanced/regional disease/visceral metastases.ConclusionGiven the methodology based on the convergence of unguided intuitive clustering of cases by experts, this new classification is relevant for clinical practice. It does not compete with staging systems, but they may complement each other, whether the objective is to select the best therapeutic approach in tumour boards or to design homogeneous groups for trials.

引用

页码：612 / 621

页数：10

共 20 条

[1] A comparison of extrinsic clustering evaluation metrics based on formal constraints [J].

Amigo, Enrique ;

Gonzalo, Julio ;

Artiles, Javier ;

Verdejo, Felisa .

INFORMATION RETRIEVAL, 2009, 12 (04) :461-486

[2]

Bagga Amit, 1998, P 36 ANN M ASS COMPU, V1, P79, DOI DOI 10.3115/980845.980859

[3]

Borg Ingwer., 2005, STAT SOCIAL SCI PUBL, V2nd, P207, DOI DOI 10.1007/0-387-28981-X

[4] Comparison and evaluation of the current staging of cutaneous carcinomas [J].

Breuninger, Helmut ;

Brantsch, Kay ;

Eigentler, Thomas ;

Haefner, Hans-Martin .

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, 2012, 10 (08) :579-586

[5] Implementation of staging systems in clinical practice for cutaneous squamous cell carcinoma [J].

Canueto, Javier .

ANNALS OF TRANSLATIONAL MEDICINE, 2019, 7

[6] A COEFFICIENT OF AGREEMENT FOR NOMINAL SCALES [J].

COHEN, J .

EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT, 1960, 20 (01) :37-46

[7]

Ester M., 1996, Proc 2nd Int Conf on Knowledge Discovery and Data Mining, P226

[8] A new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Creation and rationale for inclusion of tumor (T) characteristics [J].

Farasat, Sharifeh ;

Yu, Siegrid S. ;

Neel, Victor A. ;

Nehal, Kishwer S. ;

Lardaro, Thomas ;

Mihm, Martin C. ;

Byrd, David R. ;

Balch, Charles M. ;

Califano, Joseph A. ;

Chuang, Alice Y. ;

Sharfman, William H. ;

Shah, Jatin P. ;

Nghiem, Paul ;

Otley, Clark C. ;

Thfaro, Anthony P. ;

Johnson, Timothy M. ;

Sober, Arthur J. ;

Liegeois, Nanette J. .

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2011, 64 (06) :1051-1059

[9]

FORGY EW, 1965, BIOMETRICS, V21, P768

[10] The future is hard to predict, even for patients with cutaneous squamous cell carcinoma [J].

Gjersvik, Petter .

BRITISH JOURNAL OF DERMATOLOGY, 2022, 186 (05) :763-763

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