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Predictive value of the 8th edition American Joint Commission Cancer (AJCC) nodal staging system for patients with cutaneous squamous cell carcinoma of the head and neck
Author(s) -
Liu Jessica,
Ebrahimi Ardalan,
Low TsuHui Hubert,
Gao Kan,
Palme Carsten E.,
Sydney Ch'ng,
Ashford Bruce G.,
Iyer N. Gopalakrishna,
Clark Jonathan R.,
Gupta Ruta
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24883
Subject(s) - medicine , cancer staging , oncology , cohort , ajcc staging system , cancer , univariate analysis , head and neck , head and neck squamous cell carcinoma , stage (stratigraphy) , head and neck cancer , staging system , multivariate analysis , surgery , paleontology , biology
Background The 8th edition American Joint Committee on Cancer (AJCC8) provides the same nodal staging system for mucosal and cutaneous squamous cell carcinoma of the head and neck (HNcSCC) and includes extranodal extension (ENE) as an adverse prognostic criterion. This study evaluates the prognostic efficacy of the AJCC8 pathologic nodal staging system (pN) for HNcSCC. Methods Univariate analysis of 382 patients with metastatic HNcSCC staged according to both the 7th (AJCC7) and the 8th edition staging systems. Results The AJCC7 pN3 category was associated with reduced disease specific survival (DSS HR 5.49; 95% CI: 1.83‐16.53; P = 0.002) and overall survival (OS HR 3.42; 95% CI: 1.54‐7.58; P = 0.002) as compared with pN1. However, no difference was observed between pN1, pN2, and pN3 categories as defined by the AJCC8. Also, when comparing Stages III and IV as defined by AJCC8, there was no difference in DSS (HR 0.75; 95% CI: 0.34‐1.67; P = 0.478) or OS (HR 0.88; 95% CI: 0.51‐1.51; P = 0.648). Conclusion The AJCC8 performed poorly as a prognostic indicator for patients with metastatic HNcSCC in this cohort. HNcSCC would benefit from a staging system that accounts for its unique biologic characteristics distinct from mucosal SCC.