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Tumor Staging Systems and Prognostic Stratification

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High-Risk Cutaneous Squamous Cell Carcinoma

Abstract

Squamous cell carcinoma (SCC) is the 2nd most common cancer diagnosed worldwide. While overall cure rates are excellent, 2–5 % of tumors recur, metastasize, and cause death. Generally accepted risk factors for recurrence and metastasis include size > 2 cm, depth beyond Clark’s Level IV or V, poorly differentiated or undifferentiated histology, location on the lip, location on the ear, perineural invasion (PNI), recurrent tumors, and tumors occurring in an immunosuppressed host. These risk factors have served as the foundation for the development of the American Joint Committee on Cancer (AJCC) and International Union Against Cancer (UICC) staging systems, as well as National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for cutaneous SCC.

In 2010, the AJCC divided cutaneous SCC staging from other nonmelanoma skin cancer staging and proposed a separate staging system based on review of available literature and expert consensus opinion. Several studies have demonstrated this new stratification system may be suboptimal and have published alternative systems which offer improved prognostic discrimination. This chapter will review the available data on high-risk cutaneous SCC, summarize the current staging and prognostic stratification systems, identify areas of ambiguity in SCC staging and outcomes, and discuss areas of research that may improve future prognostic stratification systems.

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Notes

  1. 1.

    Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Basal Cell and Squamous Cell Skin Cancers V.2.2014. © National Comprehensive Cancer Network, Inc 2014. All rights reserved. Accessed [July 7, 2014]. To view the most recent and complete version of the guideline, go online to NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

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Authors and Affiliations

  1. Department of Dermatology, Mayo Medical School, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Anokhi Jambusaria-Pahlajani MD, MSCE

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  1. Anokhi Jambusaria-Pahlajani MD, MSCE
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Correspondence to Anokhi Jambusaria-Pahlajani MD, MSCE .

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Editors and Affiliations

  1. Brigham & Women's Hosp., Dept of Derm., Mohs & Dermatologic Surgery Center, Jamaica Plain, Massachusetts, USA

    Chrysalyne D. Schmults

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Jambusaria-Pahlajani, A. (2016). Tumor Staging Systems and Prognostic Stratification. In: Schmults, C. (eds) High-Risk Cutaneous Squamous Cell Carcinoma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47081-7_2

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  • DOI: https://doi.org/10.1007/978-3-662-47081-7_2

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