Assessment of the new nodal classification for cutaneous squamous cell carcinoma and its effect on patient stratification.

BACKGROUND The American Joint Committee on Cancer (AJCC) substantially changed the staging of cutaneous squamous cell carcinoma (SCC) in the seventh edition of its staging manual. Although the system is well established in mucosal SCC, very little data are available on its prognostic value in cutaneous SCC. METHODS We conducted a multivariable analysis of 672 patients with metastatic cutaneous SCC from 2 prospective cancer center databases. RESULTS The differentiation between N1 and N2 subgroups demonstrate little prognostic importance in cutaneous SCC, whereas survival is significantly worse for N3. CONCLUSION Although the introduction of a unified N system for mucosal SCC and cutaneous SCC has added complexity, it does not translate into optimal distribution and stratification for metastatic cutaneous SCC.