第八版美国癌症联合委员会分期系统 T3 期皮肤鳞状细胞癌中预后亚组的定义：暂定 T3 期亚分类。

Definition of prognostic subgroups in the T3 stage of the eighth edition of the American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Tentative T3 stage subclassification.

机构信息

Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain.

Instituto de Investigación Biomédica de Salamanca, Hospital Universitario de Salamanca, Salamanca, Spain; Instituto de Biologia Molecular y Celular del Cancer (IBMCC) - Consejo Superior de Investigaciones Científicas (CSIC), Laboratory 12, Campus Miguel de Unamuno, Salamanca, Spain; Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain.

出版信息

J Am Acad Dermatol. 2021 Nov;85(5):1168-1177. doi: 10.1016/j.jaad.2020.03.088. Epub 2020 Apr 9.

DOI:10.1016/j.jaad.2020.03.088

PMID:32278798

Abstract

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.

摘要

背景

尽管第八版美国癌症联合委员会分期系统（AJCC8）在预测皮肤鳞状细胞癌（CSCC）预后方面优于 AJCC7，但 T3 期具有可变的预后。

目的

定义 T3-AJCC8 CSCC 的预后亚组。

方法

回顾性队列研究了 196 例原发性 T3-AJCC8 CSCC。我们使用定义 T3 CSCC 的 6 个危险因素进行多维尺度分析。通过竞争风险分析分析获得的组的预后。

结果

第 1 组的特征是肿瘤厚度大于 6mm（不侵犯皮下脂肪），单独或与至少 4cm 的肿瘤宽度结合。第 2 组的特征是存在皮下脂肪侵犯或神经受累（≥0.1mm，或真皮更深）。第 3 组的特征是同时存在 T3b 危险因素，或存在 3 个或更多危险因素。第 3 组（暂定名为 T3c）患者的疾病特异性不良结局事件和主要事件的预后最差，第 2 组（T3b）的风险中等，第 1 组（T3a）的预后最好（疾病特异性不良结局事件：风险比[HR]，1.94；P =.00009；主要事件：HR，2.55；P =.00001；疾病特异性死亡：HR，10.25；P =.0009）。