Original articleA new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Creation and rationale for inclusion of tumor (T) characteristics
Section snippets
Methods
In 2006, the AJCC executive committee established the NMSC staging committee under the direction of Dr Arthur Sober. The committee was charged with responsibility of establishing new staging systems for MCC and cSCC separate from the existing NMSC staging system because of their metastatic potential. The MCC staging system is described and the NMSC chapter will be discontinued from the AJCC classification. There were two main objectives for the new cSCC staging system that is included in the
Results
The 6th edition10 (Table I) relied on the TNM staging system, classifying patients into primary tumor (T), regional lymph nodes (N), and distant metastasis (M). Although histopathologic grade (G) was recognized as significant and included in the characterization, this feature was not included in final stage grouping because the importance of grade was not established for all types of NMSC. In the 7th edition,9 the overall TNM staging concept is maintained but the G designation is eliminated
Discussion
cSCC poses a significant health concern because of its metastatic potential. cSCC is thought to claim approximately 2500 lives per year in the United States, almost a third the number of Americans who die from melanoma each year.3 Although prognosis and survival-based outcomes have been studied for over 25 years for melanoma, comparatively little is known in terms of the prognostic variables affecting cSCC survival. The incidence of aggressive or advanced cSCC may be increasing for several
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Dr Liégeois is supported with a Career Development Award from the Dermatology Foundation.
Disclosure: Dr Liégeois is president and founder of Meridian Skin Care Limited. The rest of the authors have no conflict of interest to declare.