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

Publication date: March 2019

Source: Journal of the American Academy of Dermatology, Volume 80, Issue 3

Author(s): Jacob J. Inda, Brian F. Kabat, Melissa C. Larson, Susan L. Slager, Christian L. Baum

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.

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