title: Comparison of the AJCC N staging system in mucosal and cutaneous squamous head and neck cancer.
abstract: OBJECTIVE
  The American Joint Committee on Cancer (AJCC) substantially changed the staging of cutaneous squamous cell carcinoma (cSCC) in the seventh edition of its staging manual. Given that oral mucosal squamous cell carcinoma (mSCC) and cSCC behave differently and affect different patient populations, the aim of this study was to provide a side-by-side comparison and to evaluate the current nodal (N) grouping for cSCC alongside oral mSCC to determine whether the same system is justified.
  
  
  METHODS
  Retrospective analysis of prospectively collected data.
  
  
  METHODS
  Multivariable analysis of 672 patients with metastatic cSCC and of 225 patients with metastatic mSCC from two prospective cancer-center databases.
  
  
  RESULTS
  While, as expected, the N grouping functioned well in mSCC in terms of distribution and stratification of patients, it performed much less favorably in cSCC. In contrast to mSCC, the different N groups demonstrate much less prognostic importance in cSCC.
  
  
  CONCLUSIONS
  Although the introduction of a unified N system for mSCC and cSCC has definite advantages, it does not translate into optimal distribution and stratification for metastatic cSCC.
  
  
  METHODS
  4.
authors.affiliation: Sydney Head and Neck Cancer Institute, The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia; Department of Otolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Brunner
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Ng
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Veness
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000556:secondary*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: SCC; TNM; nodal; staging