Comparison of tumor staging systems for cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia

Jacob J. Inda, Brian F. Kabat, Melissa C. Larson, Susan L Slager, Christian Baum

Research output: Contribution to journalArticle

Abstract

Background: Patients with chronic lymphocytic leukemia (CLL) are at increased risk for poor outcomes as a result of cutaneous squamous cell carcinoma (CSCC). Objective: To compare the relative effectiveness of tumor staging systems for CSCC in a well-defined cohort of patients with CLL. Methods: This retrospective outcomes study included 454 CSCC tumors among 161 patients with underlying CLL who were evaluated at a single academic medical center. Each tumor was staged according to Brigham and Women's Hospital (BWH), Union for International Cancer Control eighth edition (UICC8), and American Joint Committee on Cancer seventh edition (AJCC7) and eighth edition (AJCC8) criteria. We compared the effectiveness of tumor risk stratification according to each system. Results: The BWH tumor staging system demonstrated superior risk stratification relative to the AJCC7 criteria (C-index, 0.725 vs 0.615; P =.036) and trended toward improved stratification relative to the AJCC8 (C-index, 0.796 vs 0.732; P =.214) and UICC8 (C-index, 0.725 vs 0.636; P =.096) staging systems. Limitations: Our study must be interpreted in the context of its retrospective design and relatively small number of adverse outcomes available for statistical analysis. Conclusions: The BWH system outperformed the AJCC7 criteria and trended toward superior risk stratification relative to both the AJCC8 and UICC8 criteria.

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Neoplasm Staging
B-Cell Chronic Lymphocytic Leukemia
Squamous Cell Carcinoma
Skin
Neoplasms
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • American Joint Committee on Cancer
  • Brigham and Women's Hospital
  • chronic lymphocytic leukemia
  • squamous cell carcinoma
  • staging
  • system
  • tumor
  • Union for International Cancer Control

ASJC Scopus subject areas

  • Dermatology

Cite this

@article{b8cc148244ab417bac534b683d2df2db,
title = "Comparison of tumor staging systems for cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia",
abstract = "Background: Patients with chronic lymphocytic leukemia (CLL) are at increased risk for poor outcomes as a result of cutaneous squamous cell carcinoma (CSCC). Objective: To compare the relative effectiveness of tumor staging systems for CSCC in a well-defined cohort of patients with CLL. Methods: This retrospective outcomes study included 454 CSCC tumors among 161 patients with underlying CLL who were evaluated at a single academic medical center. Each tumor was staged according to Brigham and Women's Hospital (BWH), Union for International Cancer Control eighth edition (UICC8), and American Joint Committee on Cancer seventh edition (AJCC7) and eighth edition (AJCC8) criteria. We compared the effectiveness of tumor risk stratification according to each system. Results: The BWH tumor staging system demonstrated superior risk stratification relative to the AJCC7 criteria (C-index, 0.725 vs 0.615; P =.036) and trended toward improved stratification relative to the AJCC8 (C-index, 0.796 vs 0.732; P =.214) and UICC8 (C-index, 0.725 vs 0.636; P =.096) staging systems. Limitations: Our study must be interpreted in the context of its retrospective design and relatively small number of adverse outcomes available for statistical analysis. Conclusions: The BWH system outperformed the AJCC7 criteria and trended toward superior risk stratification relative to both the AJCC8 and UICC8 criteria.",
keywords = "American Joint Committee on Cancer, Brigham and Women's Hospital, chronic lymphocytic leukemia, squamous cell carcinoma, staging, system, tumor, Union for International Cancer Control",
author = "Inda, {Jacob J.} and Kabat, {Brian F.} and Larson, {Melissa C.} and Slager, {Susan L} and Christian Baum",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jaad.2018.08.018",
language = "English (US)",
journal = "Journal of the American Academy of Dermatology",
issn = "0190-9622",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Comparison of tumor staging systems for cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia

AU - Inda, Jacob J.

AU - Kabat, Brian F.

AU - Larson, Melissa C.

AU - Slager, Susan L

AU - Baum, Christian

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Patients with chronic lymphocytic leukemia (CLL) are at increased risk for poor outcomes as a result of cutaneous squamous cell carcinoma (CSCC). Objective: To compare the relative effectiveness of tumor staging systems for CSCC in a well-defined cohort of patients with CLL. Methods: This retrospective outcomes study included 454 CSCC tumors among 161 patients with underlying CLL who were evaluated at a single academic medical center. Each tumor was staged according to Brigham and Women's Hospital (BWH), Union for International Cancer Control eighth edition (UICC8), and American Joint Committee on Cancer seventh edition (AJCC7) and eighth edition (AJCC8) criteria. We compared the effectiveness of tumor risk stratification according to each system. Results: The BWH tumor staging system demonstrated superior risk stratification relative to the AJCC7 criteria (C-index, 0.725 vs 0.615; P =.036) and trended toward improved stratification relative to the AJCC8 (C-index, 0.796 vs 0.732; P =.214) and UICC8 (C-index, 0.725 vs 0.636; P =.096) staging systems. Limitations: Our study must be interpreted in the context of its retrospective design and relatively small number of adverse outcomes available for statistical analysis. Conclusions: The BWH system outperformed the AJCC7 criteria and trended toward superior risk stratification relative to both the AJCC8 and UICC8 criteria.

AB - Background: Patients with chronic lymphocytic leukemia (CLL) are at increased risk for poor outcomes as a result of cutaneous squamous cell carcinoma (CSCC). Objective: To compare the relative effectiveness of tumor staging systems for CSCC in a well-defined cohort of patients with CLL. Methods: This retrospective outcomes study included 454 CSCC tumors among 161 patients with underlying CLL who were evaluated at a single academic medical center. Each tumor was staged according to Brigham and Women's Hospital (BWH), Union for International Cancer Control eighth edition (UICC8), and American Joint Committee on Cancer seventh edition (AJCC7) and eighth edition (AJCC8) criteria. We compared the effectiveness of tumor risk stratification according to each system. Results: The BWH tumor staging system demonstrated superior risk stratification relative to the AJCC7 criteria (C-index, 0.725 vs 0.615; P =.036) and trended toward improved stratification relative to the AJCC8 (C-index, 0.796 vs 0.732; P =.214) and UICC8 (C-index, 0.725 vs 0.636; P =.096) staging systems. Limitations: Our study must be interpreted in the context of its retrospective design and relatively small number of adverse outcomes available for statistical analysis. Conclusions: The BWH system outperformed the AJCC7 criteria and trended toward superior risk stratification relative to both the AJCC8 and UICC8 criteria.

KW - American Joint Committee on Cancer

KW - Brigham and Women's Hospital

KW - chronic lymphocytic leukemia

KW - squamous cell carcinoma

KW - staging

KW - system

KW - tumor

KW - Union for International Cancer Control

UR - http://www.scopus.com/inward/record.url?scp=85060058617&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060058617&partnerID=8YFLogxK

U2 - 10.1016/j.jaad.2018.08.018

DO - 10.1016/j.jaad.2018.08.018

M3 - Article

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

SN - 0190-9622

ER -