期刊
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
卷 85, 期 5, 页码 1168-1177出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2020.03.088
关键词
AJCC8; cutaneous squamous cell carcinoma; prognosis; skin cancer; staging
类别
资金
- Instituto de Salud Carlos III [PI18/000587]
- cofinanciacion Fondo Europeo de Desarrollo Regional [FEDER]
- Gerencia Regional de Salud de Castilla y Leon [GRS 1835/A/18]
- Programa de Intensificacion de la Actividad Investigadora de la Gerencia Regional de Salud de Castilla y Leon, Spain [INT/M/10/19]
A retrospective study on 196 primary T3-AJCC8 CSCCs identified three prognostic subgroups: T3a, T3b, and T3c, with T3c patients having the worst prognosis and T3a patients having the best prognosis for disease-specific poor outcome events and major events.
Background: Although the eighth edition of the American Joint Committee on Cancer staging system (AJCC8) provides improved prognosis stratification of cutaneous squamous cell carcinoma (CSCC) over AJCC7, T3 has a variable prognosis. Objective: To define prognostic subgroups in T3-AJCC8 CSCC. Methods: Retrospective cohort study of 196 primary T3-AJCC8 CSCCs. We conducted multidimensional scaling analysis using the 6 risk factors that define T3 CSCCs. The prognoses of the groups obtained were analyzed by means of competing risk analysis. Results: Group 1 was characterized by a tumor thickness greater than 6 mm (without invasion beyond the subcutaneous fat), alone or in combination with a tumor width of at least 4 cm. Group 2 was characterized by the presence of either invasion beyond the subcutaneous fat or by the involvement of nerves (>= 0.1 mm, or deeper than the dermis). Group 3 was characterized by the combination of both T3b risk factors, or of 3 or more risk factors. Group 3 (tentatively named T3c) patients had the worst prognosis for disease-specific poor outcome events and major events, Group 2 (T3b) had intermediate risk, and Group 1 (T3a) had the best prognosis (disease-specific poor outcome events: hazard ratio [HR], 1.94; P = .00009; major events: HR, 2.55; P = .00001; disease-specific death: HR, 10.25; P = .0009). Limitations: Retrospective study. Conclusions: There is statistically significant evidence that T3-AJCC8 may be classified into distinct prognostic subgroups.
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