Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines
Recent guidelines from the American Joint Committee on Cancer (AJCC) and National Comprehensive Cancer Network (NCCN) have been proposed for the assessment of “high-risk” cutaneous squamous cell carcinomas (cSCCs). Though different in perspective, both guidelines share the common goals of trying to...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Skin Cancer |
| Online Access: | http://dx.doi.org/10.1155/2014/154340 |
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| author | Melinda B. Chu Jordan B. Slutsky Maulik M. Dhandha Brandon T. Beal Eric S. Armbrecht Ronald J. Walker Mark A. Varvares Scott W. Fosko |
| author_facet | Melinda B. Chu Jordan B. Slutsky Maulik M. Dhandha Brandon T. Beal Eric S. Armbrecht Ronald J. Walker Mark A. Varvares Scott W. Fosko |
| author_sort | Melinda B. Chu |
| collection | DOAJ |
| description | Recent guidelines from the American Joint Committee on Cancer (AJCC) and National Comprehensive Cancer Network (NCCN) have been proposed for the assessment of “high-risk” cutaneous squamous cell carcinomas (cSCCs). Though different in perspective, both guidelines share the common goals of trying to identify “high-risk” cSCCs and improving patient outcomes. Thus, in theory, both definitions should identify a similar proportion of “high-risk” tumors. We sought to evaluate the AJCC and NCCN definitions of “high-risk” cSCCs and to assess their concordance. Methods. A retrospective review of head and neck cSCCs seen by an academic dermatology department from July 2010 to November 2011 was performed. Results. By AJCC criteria, most tumors (n=211,82.1%) were of Stage 1; 46 tumors (13.9%) were of Stage 2. Almost all were of Stage 2 due to size alone (≥2 cm); one tumor was “upstaged” due to “high-risk features.” Using the NCCN taxonomy, 231 (87%) of tumors were “high-risk.” Discussion. This analysis demonstrates discordance between AJCC and NCCN definitions of “high-risk” cSCC. Few cSCCs are of Stage 2 by AJCC criteria, while most are “high-risk” by the NCCN guidelines. While the current guidelines represent significant progress, further studies are needed to generate a unified definition of “high-risk” cSCC to optimize management. |
| format | Article |
| id | doaj-art-a0f10a7894734ed1a409a8424340e252 |
| institution | Kabale University |
| issn | 2090-2905 2090-2913 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Skin Cancer |
| spelling | doaj-art-a0f10a7894734ed1a409a8424340e2522025-02-03T01:03:33ZengWileyJournal of Skin Cancer2090-29052090-29132014-01-01201410.1155/2014/154340154340Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network GuidelinesMelinda B. Chu0Jordan B. Slutsky1Maulik M. Dhandha2Brandon T. Beal3Eric S. Armbrecht4Ronald J. Walker5Mark A. Varvares6Scott W. Fosko7Department of Dermatology, Saint Louis University, 1402 S. Grand Boulevard, 4th Floor, St. Louis, MO 63104, USAStony Brook School of Medicine, Department of Dermatology, 181 N. Belle Mead Road, Suite 5, East Setauket, NY 11733, USADepartment of Dermatology, Saint Louis University, 1402 S. Grand Boulevard, 4th Floor, St. Louis, MO 63104, USASchool of Medicine, Saint Louis University, 1402 S. Grand Boulevard, St. Louis, MO 63104, USACenter for Outcomes Research, Saint Louis University, 3545 Lafayette Avenue, 4th Floor, St. Louis, MO 63110, USADepartment of Otolaryngology-Head and Neck Surgery, Saint Louis University, 3635 Vista Avenue, St. Louis, MO 63110, USADepartment of Otolaryngology-Head and Neck Surgery, Saint Louis University, 3635 Vista Avenue, St. Louis, MO 63110, USADepartment of Dermatology, Saint Louis University, 1402 S. Grand Boulevard, 4th Floor, St. Louis, MO 63104, USARecent guidelines from the American Joint Committee on Cancer (AJCC) and National Comprehensive Cancer Network (NCCN) have been proposed for the assessment of “high-risk” cutaneous squamous cell carcinomas (cSCCs). Though different in perspective, both guidelines share the common goals of trying to identify “high-risk” cSCCs and improving patient outcomes. Thus, in theory, both definitions should identify a similar proportion of “high-risk” tumors. We sought to evaluate the AJCC and NCCN definitions of “high-risk” cSCCs and to assess their concordance. Methods. A retrospective review of head and neck cSCCs seen by an academic dermatology department from July 2010 to November 2011 was performed. Results. By AJCC criteria, most tumors (n=211,82.1%) were of Stage 1; 46 tumors (13.9%) were of Stage 2. Almost all were of Stage 2 due to size alone (≥2 cm); one tumor was “upstaged” due to “high-risk features.” Using the NCCN taxonomy, 231 (87%) of tumors were “high-risk.” Discussion. This analysis demonstrates discordance between AJCC and NCCN definitions of “high-risk” cSCC. Few cSCCs are of Stage 2 by AJCC criteria, while most are “high-risk” by the NCCN guidelines. While the current guidelines represent significant progress, further studies are needed to generate a unified definition of “high-risk” cSCC to optimize management.http://dx.doi.org/10.1155/2014/154340 |
| spellingShingle | Melinda B. Chu Jordan B. Slutsky Maulik M. Dhandha Brandon T. Beal Eric S. Armbrecht Ronald J. Walker Mark A. Varvares Scott W. Fosko Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines Journal of Skin Cancer |
| title | Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines |
| title_full | Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines |
| title_fullStr | Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines |
| title_full_unstemmed | Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines |
| title_short | Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines |
| title_sort | evaluation of the definitions of high risk cutaneous squamous cell carcinoma using the american joint committee on cancer staging criteria and national comprehensive cancer network guidelines |
| url | http://dx.doi.org/10.1155/2014/154340 |
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