Impact of AJCC 8 pT staging in cutaneous head and neck squamous cell carcinoma in a nonselected real-world patient sample

Objective Our aim was to evaluate characteristics associated with worse survival and the effectiveness of AJCC 8 in a real-world cohort of HNCSCC from South Brazil. Methods A 10-year retrospective cohort study (2011-2020) at a tertiary care center comprising 647 HNCSCC excised from 435 patients. Results At multivariable analysis, ear/nose/zygomatic or periorbital site, compromised or exiguous margins, and advanced pT stage were independent factors associated to DFS, while age, pN, and loco-regional recurrence were independent factors associated to DSS. Cox-regression multivariable models showed that the pT stage was statistically significant for the DFS, but not DSS. A significant distinction was only observed between T1 and T2. Conclusion It was only in the lower categories of AJCC 8 (T1 and T2) that we were able to demonstrate the ability to stratify tumors with a significant risk of poor disease-related outcomes.

Automated summary

In a cohort of HNCSCC patients from South Brazil, ear/nose/zygomatic or periorbital site, compromised or exiguous margins, and advanced pT stage were associated with worse disease-free survival (DFS), while age, pN stage, and loco-regional recurrence were associated with worse disease-specific survival (DSS). AJCC 8 was able to stratify tumors with a significant risk of poor outcomes only in the lower categories (T1 and T2).