Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, New South Wales, Australia.
Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.
Head Neck. 2021 Feb;43(2):558-567. doi: 10.1002/hed.26512. Epub 2020 Oct 29.
The 8th edition American Joint Committee on Cancer staging manual (AJCC8) introduced a separate staging system for head and neck cutaneous squamous cell carcinoma (HNcSCC) which parallels mucosal SCC and incorporates extranodal extension (ENE). This study aims to evaluate its prognostic utility.
Univariate analysis of 1146 patients with metastatic HNcSCC from four Australian cancer centers was performed according to both AJCC 7th (AJCC7) and the 8th editions.
AJCC8 increased classification of 924 (80.6%) patients to either pN2a or pN3b and 341 patients (29.8%) from stage III to IV compared to AJCC7. The disease-specific survival (DSS) was not significantly different between pN1, pN2 or pN3a categories per AJCC8. Estimates of model performance for the AJCC8 pN staging revealed modest predictive capacity (Harrell's C of 0.62 for DSS).
The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator.
第 8 版美国癌症联合委员会分期手册（AJCC8）为头颈部皮肤鳞状细胞癌（HNcSCC）引入了一个独立的分期系统，与黏膜 SCC 平行，并纳入了结外扩展（ENE）。本研究旨在评估其预后实用性。
对来自澳大利亚四家癌症中心的 1146 例转移性 HNcSCC 患者进行了 AJCC7 和 AJCC8 分期的单因素分析。
AJCC8 将 924 例（80.6%）患者的分类分别提升为 pN2a 或 pN3b，341 例（29.8%）患者从 AJCC7 的 III 期提升至 IV 期。根据 AJCC8，pN1、pN2 或 pN3a 分类的疾病特异性生存率（DSS）无显著差异。AJCC8 pN 分期的模型性能估计显示出适度的预测能力（DSS 的 Harrell C 为 0.62）。
AJCC8 分期系统的 pN 分类风险分层作为预后指标的表现不佳。
