基于美国癌症联合委员会第八版和布莱根妇女医院分期系统对免疫抑制患者皮肤鳞状细胞癌不良结局进行分层。

Stratification of Poor Outcomes for Cutaneous Squamous Cell Carcinoma in Immunosuppressed Patients Using the American Joint Committee on Cancer Eighth Edition and Brigham and Women's Hospital Staging Systems.

机构信息

*All authors are affiliated with the The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York.

出版信息

Dermatol Surg. 2019 Sep;45(9):1117-1124. doi: 10.1097/DSS.0000000000001774.

DOI:10.1097/DSS.0000000000001774

PMID:30640779

Abstract

BACKGROUND

Staging systems for cutaneous squamous cell carcinoma (CSCC) include Brigham and Women's Hospital (BWH) and American Joint Committee on Cancer staging system, eighth edition (AJCC-8).

OBJECTIVE

To evaluate and compare AJCC-8 and BWH staging systems for CSCC in immunosuppressed patients.

MATERIALS AND METHODS

A retrospective cohort study of immunosuppressed patients diagnosed with primary CSCC from 2012 to 2016. The main end point was any poor outcome (PO), which included local recurrence, nodal metastasis, and disease-specific death.

RESULTS

Fifty-eight immunosuppressed patients had 263 CSCCs. Fifty percent of tumors were AJCC-8 T1, 44.7% T2, and 4.8% T3. Fifty percent of tumors were BWH T1, 48.5% T2a, 1.3% T2b, and 0.4% T3. Risk of PO for AJCC-8 was 1.7%, 8.8%, and 36.4% for T1, T2, and T3, respectively (p < .01). Risk of PO for BWH was 1.8%, 9.9%, 33.3%, and 100.0% for T1, T2a, T2b, and T3, respectively (p < .01). Thirty-six percent of AJCC-8 T3/T4 tumors had POs compared with 5.1% in low T1/T2 stages (p = .002). Fifty percent of BWH T2b/T3 tumors had POs compared with 5.3% in low T1/T2a stages (p = .01).

CONCLUSION

AJCC-8 and BWH staging systems stratify CSCC with similar distinctiveness, homogeneity, and monotonicity for immunosuppressed patients.

摘要

背景

皮肤鳞状细胞癌（CSCC）的分期系统包括布莱根妇女医院（BWH）和美国癌症联合委员会分期系统第八版（AJCC-8）。

目的

评估和比较 AJCC-8 与 BWH 分期系统在免疫抑制患者中的 CSCC 分期。

材料和方法

这是一项回顾性队列研究，纳入了 2012 年至 2016 年期间被诊断为原发性 CSCC 的免疫抑制患者。主要终点是任何不良结局（PO），包括局部复发、淋巴结转移和疾病特异性死亡。

结果

58 例免疫抑制患者共有 263 个 CSCC。50%的肿瘤为 AJCC-8 T1，44.7%为 T2，4.8%为 T3。50%的肿瘤为 BWH T1，48.5%为 T2a，1.3%为 T2b，0.4%为 T3。AJCC-8 的 PO 风险分别为 T1、T2 和 T3 的 1.7%、8.8%和 36.4%（p<0.01）。BWH 的 PO 风险分别为 T1、T2a、T2b 和 T3 的 1.8%、9.9%、33.3%和 100.0%（p<0.01）。与低 T1/T2 期（5.1%）相比，AJCC-8 的 T3/T4 肿瘤中有 36%发生 PO，而 BWH 的 T2b/T3 肿瘤中有 5.1%发生 PO（p=0.002）。