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Soo Park, MD
Soo Park, MD
Posted: Tuesday, February 22, 2022
Marlies Wakkee, MD, PhD, of Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands, and colleagues assessed the predictive performance capabilities of four current staging systems in cutaneous squamous cell carcinoma: the American Joint Committee on Cancer, 8th edition (AJCC8), Brigham and Women’s Hospital (BMW), Tübingen, and Salamanca T3 refinement. They found the BWH staging system to be the most accurate to determine high-risk patients who might require close follow-up or adjuvant therapy. Additionally, the investigators suggest that AJCC8 would be most appropriate in correctly identifying which patients may safely skip follow-up visits. The findings for this study were published in the British Journal of Dermatology.
“With emerging treatments being developed to treat advanced cutaneous squamous cell carcinoma, identifying which tumors have the highest risk profile is essential and currently needs improvement for all staging systems,” said the investigators.
This nested case-control study was conducted between 2013 and 2015. Data from the National Disease Registration Service, England, were used to identify all potential cases of metastatic cutaneous squamous cell carcinoma. The performance of four cutaneous squamous cell carcinoma staging systems was validated in terms of distinctiveness, homogeneity, monotonicity, specificity, positive predictive value, negative predictive value, and c-index.
The study included 887 metastatic cutaneous squamous cell carcinoma cases and 887 non-metastatic cutaneous squamous cell carcinoma controls. The investigators found the BWH staging system to have the highest specificity of metastasis at 92.8%, positive predictive value at 13.2%, and c-index at 0.84. The AJCC8 staging system showed the highest negative predictive value at 99.2%, homogeneity, and monotonicity compared with the BWH and Tübingen systems in terms of diameter and thickness classifications (P < .001). On the other hand, Salamanca T3 refinement did not show any improvement in metastatic cutaneous squamous cell carcinoma staging. Overall, the BWH staging system showed the highest c-index, which is singularly the best indicator of the predictive capability of a staging system. However, the predictive positive value of all staging systems was suboptimal (5%–13%).
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.
British Journal of Dermatology
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