Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study

Peter P. Luk; Ardalan Ebrahimi; Michael J. Veness; Lachlan McDowell; Matthew Magarey; Kan Gao; Carsten E. Palme; Jonathan R. Clark; Ruta Gupta

doi:10.1002/hed.26512

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study

Peter P. Luk, Ardalan Ebrahimi, Michael J. Veness, Lachlan McDowell, Matthew Magarey, Kan Gao, Carsten E. Palme, Jonathan R. Clark, Ruta Gupta^*

^*Corresponding author for this work

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12 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator.

Original language	English
Pages (from-to)	558-567
Number of pages	10
Journal	Head and Neck
Volume	43
Issue number	2
DOIs	https://doi.org/10.1002/hed.26512
Publication status	Published - Feb 2021

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Luk, P. P., Ebrahimi, A., Veness, M. J., McDowell, L., Magarey, M., Gao, K., Palme, C. E., Clark, J. R., & Gupta, R. (2021). Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study. Head and Neck, 43(2), 558-567. https://doi.org/10.1002/hed.26512

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title = "Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study",

abstract = "Background: 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. Methods: 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. Results: 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). Conclusions: The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator.",

keywords = "American Joint Committee on Cancer, head and neck cutaneous squamous cell carcinoma, nodal metastases, prognosis, staging",

author = "Luk, {Peter P.} and Ardalan Ebrahimi and Veness, {Michael J.} and Lachlan McDowell and Matthew Magarey and Kan Gao and Palme, {Carsten E.} and Clark, {Jonathan R.} and Ruta Gupta",

note = "Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC",

year = "2021",

month = feb,

doi = "10.1002/hed.26512",

language = "English",

volume = "43",

pages = "558--567",

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Luk, PP, Ebrahimi, A, Veness, MJ, McDowell, L, Magarey, M, Gao, K, Palme, CE, Clark, JR & Gupta, R 2021, 'Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study', Head and Neck, vol. 43, no. 2, pp. 558-567. https://doi.org/10.1002/hed.26512

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study. / Luk, Peter P.; Ebrahimi, Ardalan; Veness, Michael J. et al.
In: Head and Neck, Vol. 43, No. 2, 02.2021, p. 558-567.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma

T2 - A multi-institutional study

AU - Luk, Peter P.

AU - Ebrahimi, Ardalan

AU - Veness, Michael J.

AU - McDowell, Lachlan

AU - Magarey, Matthew

AU - Gao, Kan

AU - Palme, Carsten E.

AU - Clark, Jonathan R.

AU - Gupta, Ruta

PY - 2021/2

Y1 - 2021/2

N2 - Background: 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. Methods: 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. Results: 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). Conclusions: The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator.

AB - Background: 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. Methods: 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. Results: 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). Conclusions: The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator.

KW - American Joint Committee on Cancer

KW - head and neck cutaneous squamous cell carcinoma

KW - nodal metastases

KW - prognosis

KW - staging

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DO - 10.1002/hed.26512

M3 - Article

SN - 1043-3074

VL - 43

SP - 558

EP - 567

JO - Head and Neck

JF - Head and Neck

IS - 2

ER -

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study

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