Abstract
This study was undertaken with the aim to compare the T stages in a series of cutaneous
squamous cell carcinoma (cSCC) patients using both the eighth edition of the Union
for International Cancer Control (UICC) TNM Classification of Malignant Tumours (TNM8)
and Brigham and Women’s Hospital (BWH) staging systems. This would allow comparison
of the two to determine suitability with regards to T stage and the effect on local
recurrence and nodal disease. This was a six-year retrospective cohort study of patients
with primary invasive cSCC of the head and neck who were diagnosed and treated at
Western Sussex Hospitals Trust in the United Kingdom between 2007 and 2012. The TNM8
and BWH staging systems were applied to these primary cSCCs. A total of 695 invasive
cSCCs treated in 604 patients over six years were identified. Most patients were male
(76%), with a mean (range) age of 81 (50-103) years. The most common location for
local recurrence was the scalp (n = 26, 58%). Regional metastasis occurred most commonly in the parotid gland (n = 20, 63%). All tumours were classified using both staging systems. Specifically, 432
tumours remained in the same T stage (61%), and 192 were downstaged (27%) and 71 upstaged
using the BWH (10%). The median (SD) follow-up time was 23 (28) months (range 1-123).
The BWH alternative staging system overlapped with the TNM8 in high-stage and low-stage
tumour assignment. The highest percentage of local recurrence and regional metastasis
occurred in T2b tumours.
Keywords
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Article info
Publication history
Published online: October 16, 2020
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© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
