美国癌症联合委员会第七版与布莱根妇女医院免疫抑制患者皮肤鳞状细胞癌肿瘤分期的比较。

Comparison of the American Joint Committee on Cancer Seventh Edition and Brigham and Women's Hospital Cutaneous Squamous Cell Carcinoma Tumor Staging in Immunosuppressed Patients.

作者信息

Gonzalez Jessica L, Cunningham Kiera, Silverman Rebecca, Madan Elena, Nguyen Bichchau M

机构信息

*Department of Dermatology, Tufts Medical Center, Boston, Massachusetts; †Tufts University School of Medicine, Boston, Massachusetts.

出版信息

Dermatol Surg. 2017 Jun;43(6):784-791. doi: 10.1097/DSS.0000000000001038.

DOI:10.1097/DSS.0000000000001038

PMID:28079640

Abstract

BACKGROUND

The American Joint Committee on Cancer 7th edition (AJCC-7) and Brigham and Women's Hospital (BWH) staging criteria for cutaneous squamous cell carcinoma (cSCC) have not been validated in immunosuppressed patients.

OBJECTIVE

To compare the AJCC-7 and BWH staging systems for cSCCs in immunosuppressed patients.

MATERIALS AND METHODS

A single-institution retrospective cohort study of cSCCs in immunosuppressed patients. Risks of local recurrence (LR), nodal metastasis (NM), in-transit metastasis, and any poor outcome (PO) were compared among AJCC-7 and BWH tumor T stages.

RESULTS

One hundred six patients had 412 primary invasive cSCCs. Eighty-five percent were AJCC-7 T1, and 15% T2. Risks of NM and PO for AJCC-7 T1 versus T2 were 0.9% versus 5% and 12.8% versus 23.3%, respectively, p < .05. Eighty-one percent of tumors were BWH T1, 18% T2a, 1% T2b, and 0.2% T3. Risk of LR for BWH T1 versus T2a was 11.4% versus 20.3%, p < .01. Risk of NM increased from 0.3% for T1 to 4.1%, 25%, and 100% for T2a, T2b, and T3, p < .05. Ninety percent of PO occurred in low-stage BWH T1/T2a.

CONCLUSION

Low T-stage cSCCs account for most POs. Brigham and Women's Hospital staging criteria better risk stratifies cSCCs in immunosuppressed patients for risk of NM and LR.

摘要

背景

美国癌症联合委员会第7版（AJCC-7）以及布莱根妇女医院（BWH）的皮肤鳞状细胞癌（cSCC）分期标准尚未在免疫抑制患者中得到验证。

目的

比较免疫抑制患者cSCC的AJCC-7和BWH分期系统。

材料与方法

一项针对免疫抑制患者cSCC的单机构回顾性队列研究。比较AJCC-7和BWH肿瘤T分期中局部复发（LR）、区域淋巴结转移（NM）、途中转移以及任何不良结局（PO）的风险。

结果

106例患者有412处原发性浸润性cSCC。85%为AJCC-7 T1期，15%为T2期。AJCC-7 T1期与T2期的NM风险和PO风险分别为0.9%对5%以及12.8%对23.3%，p < 0.05。81%的肿瘤为BWH T1期，18%为T2a期，1%为T2b期，0.2%为T3期。BWH T1期与T2a期的LR风险分别为11.4%对20.3%，p < 0.01。NM风险从T1期的0.3%增加至T2a期的4.1%、T2b期的25%以及T3期的100%，p < 0.05。90%的PO发生在低分期的BWH T1/T2a期。