Collaborative Multicenter Prognostication and Staging System for Cutaneous Squamous Cell Carcinoma (COMPASS-SCC).

BACKGROUNDThe 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.

OBJECTIVETo develop a novel CSCC staging system (COMPASS-SCC) with improved performance.

METHODSThis 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.

RESULTS20,972 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.

LIMITATIONSRetrospective design.

CONCLUSIONCOMPASS-SCC is a novel CSCC staging system with improved prognostic performance compared to AJCC8 and BWH.

Abstract from PubMed