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Collaborative Multicenter Prognostication and Staging System for Cutaneous Squamous Cell Carcinoma (COMPASS-SCC)
Kathryn T Shahwan1, Lindsey M Voller1, Neil K Jairath2
1Department of Dermatology, The Ohio State University Medical Center, Columbus OH, USA.
Background:
The American Joint Committee on Cancer (AJCC8) and Brigham and Women's Hospital are the most commonly used staging systems for cutaneous squamous cell carcinoma (CSCC). Both have limitations.
Objective:
To develop a novel CSCC staging system (COMPASS-SCC) with improved performance.
Methods:
This study utilized a retrospective CSCC database from 12 international centers. Univariable and multivariable Fine and Gray models assessed risk factors' impact on major poor outcomes (MPO; metastasis and disease specific death) for inclusion and weight in the staging system. Sensitivity, specificity, positive and negative predictive value (PPV/NPV), Area Under the Receiver Operating Characteristic curve (AUROC), and Uno's c-index were calculated.
Results:
20,972 primary tumors were included. Diameter (1 point for ≥2 but <5, 2 points for ≥5 centimeters), depth (1 point for beyond fat or >6 millimeters), differentiation (1 point for moderate, 2 points for poor), large-caliber perineural invasion (1 point), and lymphovascular invasion (1 point) were included in the system, with stages from T1 (0 points) to T4 (≥5 points). Sensitivity, NPV, AUROC, and Uno's c-index were significantly higher in COMPASS-SCC than in AJCC8 and BWH.
Limitations:
Retrospective design.
Conclusion:
COMPASS-SCC is a novel CSCC staging system with improved prognostic performance compared to AJCC8 and BWH.
