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

Luk, Peter P.; Ebrahimi, Ardalan; Veness, Michael J.; McDowell, Lachlan; Magarey, Matthew; Gao, Kan; Clark, Jonathan; Gupta, Ruta

doi:10.1002/hed.26512

Cited by 10 publications

(8 citation statements)

References 29 publications

(55 reference statements)

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“…Given that cSCC is the most prevalent type of nonmelanoma skin malignancy with a high risk of metastasis, being able to identify the few patients who develop metastases would have a significant impact on public health, especially in areas with notable sun exposure ( 50 ). The identification of CTCs as indicators of metastatic disease can also directly influence therapeutic practice via the early detection of recurrence and the development of specialized treatment procedures for high-risk patients ( 51 ). It could be hypothesized that using mesenchymal and novel biomarkers to broaden CTC markers in a positive selection model may enable higher levels of detection and enhance understanding of the metastatic process in cSCC.…”

Section: Metastasismentioning

confidence: 99%

Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma (Review)

Iancu,

Fulga,

Vesa

et al. 2024

Mol Clin Oncol

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According to current predictions, one-fifth of all Americans will develop skin cancer during their lifetime. Cutaneous squamous cell carcinoma (cSCC) most commonly occurs in the head and neck region, which is the area of the body with the highest level of sun exposure. High-risk head and neck cSCC (HNcSCC) is a broad category with numerous high-risk factors that are associated with unfavorable results. In cSCC staging systems, clinical and tumor traits that are likely to result in poor outcomes are identified. Metastasis occurs in ~2.5% of patients with cSCC, most often in the local lymph nodes, and there is some indication that lymph node metastasis has a distinct pattern based on the tumor site. Current findings on tumor molecular targets have suggested the use of systemic treatments, particularly immunotherapy (such as cemiplimab, pembrolizumab and nivolumab), over radiotherapy or chemotherapy for this type of metastasis. However, when used simultaneously with immunotherapy, radiotherapy may be beneficial in the treatment of metastatic HNcSCC by improving the efficacy of immunotherapy. The present review aims to assess the existing literature on metastatic HNcSCC pathways and treatment options, in order to define current and future directions. Notably, there is an urgent need to identify patients who may benefit from local or systemic cancer treatments. The treatment of lymph node metastasis presents a therapeutic challenge and requires comprehensive management.

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Section: Metastasismentioning

confidence: 99%

Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma (Review)

Iancu,

Fulga,

Vesa

et al. 2024

Mol Clin Oncol

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“…4 Although the tumor-node-metastasis (TNM) cancer staging, particular primary location, human papilloma virus (HPV), bacterial expression (e.g., Porphyromonas gingivalis, Fusobacterium nucleatum, etc. ), radiotherapy, chemotherapy, and immunotherapy regimens have prognostic significance for HNC patients, [7][8][9][10][11][12][13] the correlation between these risk factors and HNC-associated VTE remains to be clarified. This present study, therefore, for the first time, sought to collect the baseline data, summarize the clinical features, evaluate the prognosis for the HNC inpatients in the authors' affiliation, and to determine the incidence of VTE in association with a recent HNC diagnosis and to further analyze the risk factors so as to develop a nomogram model for predicting VTE in hospitalized HNC patients.…”

Section: Conclusion and Relevancementioning

confidence: 99%

Risk assessment of venous thromboembolism in head and neck cancer patients and its establishment of a prediction model

Li,

He,

Wang

et al. 2023

Head & Neck

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ImportanceVenous thromboembolism (VTE) is closely relevant to head and neck cancer (HNC) prognosis, but little data exist on the risk prediction of VTE in patients with HNC.ObjectiveTo study the risk factors regarding VTE in HNC patients and construct a nomogram model for its prediction.Design, Setting, and ParticipantsA cross‐sectional retrospective study was implemented to comparatively analyze 220 HNC patients from January 2018 to December 2021. The Lasso algorithm was used to optimize the selection of variables. A nomogram model for predicting HNC‐associated VTE was established using multivariate logistic regression analysis. Internal validation of the model was performed by bootstrap resampling (1000 times). Calibration plot and decision curve analysis (DCA) were applied to evaluate the calibration capability of the prediction model.Main Outcome and MeasureThe demographics, medical history, blood biochemical indicators, and modalities of treatment were included for analysis.ResultsThe incidence of HNC‐associated VTE was 2.8% (55/1967) in authors' affiliation. Five variables of risk factors, including surgery, radiochemotherapy, D‐dimer, aspartate transaminase, and globulin, were screened and selected as predictors by Lasso algorithm. A prediction model that incorporated these independent predictors was developed and presented as the nomogram. The model showed good discrimination with a C‐index of 0.972 (95% CI: 0.934–0.997), and had an area under the receiver operating characteristic curve value of 0.981 (p < 0.001, 95% CI: 0.964–0.998). The calibration curve displayed good agreement of the predicted probability with the actual observed probability for HNC‐associated VTE. The DCA plot showed that the application of this nomogram was associated with net benefit gains in clinical practice.Conclusions and RelevanceThe high‐performance nomogram model developed in this study may help early diagnose the risk of VTE in HNC patients and to guide individualized decision‐making on thromboprophylaxis.

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“…In 2020, Luk et al evaluated the AJCC 8th edition and compared its prognostic utility in an Australian multicentre study of 1146 HNcSCC patients with regional metastasis [ 25 ]. In this cohort, the N category was upstaged in 80.9% of patients by the AJCC 8th edition due to the presence of ENE, 29.9% were upstaged from stage III to IV, resulting in 90.6% of patients with nodal metastases being assigned to stage IV disease.…”

Section: Ajcc 8th Editionmentioning

confidence: 99%

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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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

Cited by 10 publications

References 29 publications

Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma (Review)

Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma (Review)

Risk assessment of venous thromboembolism in head and neck cancer patients and its establishment of a prediction model

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

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