Comparative Performance of Four Staging Classifications to Select «High-Risk» Head and Neck Cutaneous Squamous Cell...

Area of Science:

• Oncology
• Dermatology
• Surgical Oncology

Background:

• Head and neck cutaneous squamous cell carcinoma (HNCSCC) management relies on accurate risk stratification.
• Existing classification systems for high-risk HNCSCC vary in their predictive capabilities.

Purpose of the Study:

• To compare the performance of the Brigham and Women's Hospital (BWH) classification against established systems.
• Evaluate the BWH classification's efficacy in predicting adverse outcomes in HNCSCC patients.

Main Methods:

• Retrospective analysis of 217 HNCSCC cases from a single tertiary care center.
• Classification of tumors as low-risk or high-risk using BWH, AJCC8, UICC8, and NCCN criteria.
• Assessment of local recurrence, lymph node recurrence, and disease-specific death rates.

Main Results:

• The BWH classification exhibited the highest specificity and positive predictive value for predicting poor outcomes and lymph node recurrence.
• Concordance indices for BWH were comparable to AJCC8 and UICC8, but superior to NCCN.
• The National Comprehensive Cancer Network (NCCN) classification demonstrated the least discriminatory power.

Conclusions:

• The BWH classification appears most suitable for predicting poor outcomes in HNCSCC.
• This finding supports the BWH system's utility in guiding clinical decision-making for high-risk HNCSCC.