The Evolution of Staging of Cutaneous Squamous Cell Carcinomas: A Structured Review

Abstract

Among non-melanoma skin cancers, cutaneous squamous cell carcinoma entails the highest morbidity and mortality, and yet there is little guidance on how to identify the subset of cutaneous squamous cell carcinomas that behave aggressively. The staging of non-melanoma skin cancers is meant to provide this guidance, by dividing patients into groups for which survival differs between groups, is similar within each group, and consistently decreases with each increasing stage group. In the present review, we explore the history of how the staging of nonmelanoma skin cancers, focusing on cutaneous squamous cell carcinomas, has evolved over time. We describe the common criticisms leveled at the American Joint Committee on Cancer (AJCC) staging rubric. We discuss alternative staging systems that have recently been proposed, and how they have stood up to validation. Finally, we preview the AJCC staging changes that will go into effect next year and lay out some future directions for the improvement of skin cancer staging.

Altered presence of extra cellular matrix components in murine skin cancer: Modulation by Azadirachta indica leaf extract

“…Non-melanoma skin cancer (NMSC) is the most common type of cancer worldwide and its incidence is persistently growing. 9 , 10 Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC) are the most common forms of NMSC. SCC is a cancer of the epidermal keratinocytes and starts in the upper squamous cells of the skin epidermis whereas, BCC is a cancer of the basal cells of the skin epidermis.…”

Epidemiological and molecular features of cutaneous squamous cell carcinoma with perineural spread

“…10 The 8 th edition AJCC staging system to be released in 2018 has appropriately acknowledged the negative prognostic significance of PNI to include the impact of nerve diameter and depth of nerve invasion. 156 This This will ideally contribute to improved awareness and understanding of CSCCHN with clinical PNI that can lead to improved patient management.…”

“…10 The new 8 th edition of the AJCC staging system will be implemented in 2018, and changes have been made in regards to PNI that more accurately reflect the significant prognostic impact of PNI. 156 Specifically, cutaneous SCC with PNI is staged as T3 if the involved nerve is deeper than the dermis or is ≥ 0.1mm diameter or if the patient has clinical PNI. Invasion into the skull base or skull base foramina is staged T4b.…”