title: Assessment of the new nodal classification for cutaneous squamous cell carcinoma and its effect on patient stratification.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Sydney Head and Neck Cancer Institute, The Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, Sydney, Australia; Department of Otolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria, Europe.
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; D001315:Australia; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000469:parasitology* / Q000628:therapy; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000145:classification*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012955:Societies, Medical; D016019:Survival Analysis
keywords: TNM; cutaneous squamous cell carcinoma; head and neck