The American Joint Committee on Cancer staging for metastatic head and neck cutaneous squamous cell carcinoma: A multi-institutional study of within-stage heterogeneity and impact on prognostic performance

被引：8

作者：

Ebrahimi, Ardalan ^{[1
,2
,3
]}

Luk, Peter P. ^{[4
]}

Low, Hubert ^{[2
]}

McDowell, Lachlan ^{[5
,6
]}

Magarey, Matthew J. R. ^{[7
]}

Smith, Paul N. ^{[1
]}

Perriman, Diana M. ^{[1
]}

Shadbolt, Bruce ^{[1
]}

Veness, Michael ^{[8
,9
]}

Gupta, Ruta ^{[4
,9
]}

Clark, Jonathan R. ^{[2
,9
]}

机构：

[1] Australian Natl Univ, Coll Hlth & Med, Med Sch, Canberra, ACT, Australia

[2] Chris OBrien Lifehouse, Sydney Head & Neck Canc Inst, Dept Head & Neck Surg, Sydney, NSW, Australia

[3] Canberra Hosp, Dept Head & Neck Surg, Canberra, ACT, Australia

[4] Royal Prince Alfred Hosp, Dept Tissue Pathol & Diagnost Oncol, Sydney, NSW, Australia

[5] Peter MacCallum Canc Ctr, Dept Radiat Oncol, Melbourne, Vic, Australia

[6] Univ Melbourne, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia

[7] Peter MacCallum Canc Ctr, Dept Surg Oncol, Melbourne, Vic, Australia

[8] Westmead Hosp, Dept Radiat Oncol, Sydney, NSW, Australia

[9] Univ Sydney, Sydney, NSW, Australia

来源：

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2020年 / 42卷 / 11期

关键词：

cancer staging; cutaneous squamous cell carcinoma; head and neck cancer; lymph node metastasis; prognosis;

D O I：

10.1002/hed.26369

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Background The American Joint Committee on Cancer (AJCC) staging for head and neck cutaneous squamous cell carcinoma (HNcSCC) stratifies risk poorly. We hypothesized that this results from prognostic heterogeneity within N and TNM groups. Methods Retrospective analysis of disease-specific survival (DSS) in a multicenter study of 1146 patients with nodal metastases from HNcSCC. Results The majority of patients were classified as pN2a or pN3b (83.1%) and TNM stage IV (90.6%). On multivariate analysis, there was statistically significant prognostic heterogeneity within these groups based on the number and size of nodal metastases, immunosuppression, and perineural invasion. When stage IV patients were categorized into low, moderate, and high-risk groups based on adverse features, there was wide variation in prognosis with 5-year DSS ranging from 90% to 60% (P < .001). Conclusions The AJCC staging system stratifies risk poorly in HNcSCC due to significant prognostic heterogeneity within pN2a, pN3b, and stage IV groups.

引用

页码：3235 / 3242

页数：8

共 8 条

[1]

Amin M.B., 2017, AJCC Cancer Staging Manual, V8th

[2] Comparing the eighth and the seventh editions of the American Joint Committee on Cancer staging system and the Brigham and Women's Hospital alternative staging system for cutaneous squamous cell carcinoma: Implications for clinical practice [J].