A critical analysis of the prognostic performance of the 8th edition American Joint Committee on Cancer staging for metastatic cutaneous squamous cell carcinoma of the head and neck

Sood, A.; Wykes, James; Roshan, David; Wang, Laura Y.; McGuinness, John; Fowler, Allan; Ebrahimi, Ardalan

doi:10.1002/hed.25599

Cited by 18 publications

(9 citation statements)

References 34 publications

(74 reference statements)

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“…Stage III and IV Kaplan–Meier curves overlapped for both DSS and OS. Similar results were reported in another study by Sood and colleagues [ 24 ].…”

Section: Ajcc 8th Editionsupporting

confidence: 92%

Evolution of Head and Neck Cutaneous Squamous Cell Carcinoma Nodal Staging—An Australian Perspective

Hurrell

Low

Ebrahimi

et al. 2022

Cancers

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Cutaneous squamous cell carcinoma of the head and neck (HNcSCC) is one of the commonest malignancies. When patients present with regional metastatic disease, treatment escalation results in considerable morbidity and survival is markedly reduced. Owing to the high incidence, Australian institutions have been at the forefront of advocating for reliable, accurate, and clinically useful staging systems that recognise the distinct biological characteristics of HNcSCC. As a result, an extensive body of literature has been produced over the past two decades, which has defined critical prognostic factors, critiqued existing staging systems, and proposed alternative staging models. Notwithstanding, a suitable staging system has proved elusive. The goal of cancer staging is to group patients according to cancer characteristics for which survival differs between groups (distinctiveness), consistently decreases with increasing stage (monotonicity), and is similar within a group (homogeneity). Despite implementing major changes based on published data, the latest edition of the American Joint Committee on Cancer (AJCC) staging manual fails to satisfy these fundamental requirements. This review chronologically explores and summarises the Australian contribution to prognostication and nodal staging of HNcSCC and highlights the ongoing challenges.

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“…Stage III and IV Kaplan–Meier curves overlapped for both DSS and OS. Similar results were reported in another study by Sood and colleagues [ 24 ].…”

Section: Ajcc 8th Editionsupporting

confidence: 92%

Evolution of Head and Neck Cutaneous Squamous Cell Carcinoma Nodal Staging—An Australian Perspective

Hurrell

Low

Ebrahimi

et al. 2022

Cancers

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“…50 On the contrary, Sood et al evaluated the incorporation of extranodal extension in the classification system. 51 In their study, the N classification was upstaged in 77% of the cases. As a result, the majority of their patients were upstaged to stage IV, which resulted in a poorer prognostic performance of the AJCC eighth edition.…”

Section: Basal Cell Carcinomamentioning

confidence: 93%

Oncodermatology of the Head and Neck

et al. 2019

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“…12,13 We recently published single-institutional studies of metastatic HNcSCC demonstrating that AJCC8 nodal staging system performs poorly at prognostic stratification of patients with metastatic HNcSCC. 14,15 The current study aims to collate data from multiple Australian cancer centers with expertise in management of HNcSCC to validate our previous single-institutional findings as well as identify factors that play a role in prognostication of metastatic HNcSCC.…”

Section: Introductionmentioning

confidence: 94%

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi‐institutional study

et al. 2020

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Background: The 8th edition American Joint Committee on Cancer staging manual (AJCC8) introduced a separate staging system for head and neck cutaneous squamous cell carcinoma (HNcSCC) which parallels mucosal SCC and incorporates extranodal extension (ENE). This study aims to evaluate its prognostic utility. Methods: Univariate analysis of 1146 patients with metastatic HNcSCC from four Australian cancer centers was performed according to both AJCC 7th (AJCC7) and the 8th editions. Results: AJCC8 increased classification of 924 (80.6%) patients to either pN2a or pN3b and 341 patients (29.8%) from stage III to IV compared to AJCC7. The disease-specific survival (DSS) was not significantly different between pN1, pN2 or pN3a categories per AJCC8. Estimates of model performance for the AJCC8 pN staging revealed modest predictive capacity (Harrell's C of 0.62 for DSS).

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A critical analysis of the prognostic performance of the 8th edition American Joint Committee on Cancer staging for metastatic cutaneous squamous cell carcinoma of the head and neck

Cited by 18 publications

References 34 publications

Evolution of Head and Neck Cutaneous Squamous Cell Carcinoma Nodal Staging—An Australian Perspective

Evolution of Head and Neck Cutaneous Squamous Cell Carcinoma Nodal Staging—An Australian Perspective

Oncodermatology of the Head and Neck

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi‐institutional study

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