{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:19:43Z","timestamp":1791040783967,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005281","name":"American Center for Mongolian Studies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Risk stratification of cutaneous squamous cell carcinoma (CSCC) is central to effective management. Despite advancements in the 8th edition of the American Joint Committee on Cancer (AJCC8) staging system, the distinctiveness of T\u2010stages remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of the Brigham and Women's Hospital (BWH) and the AJCC8 staging systems in predicting poor outcomes in head and neck (HN) CSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective, multinational cohort study of CSCCs diagnosed between January 10, 1991, and December 31, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twelve centers across the United States (10), Spain (1), and Brazil (1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with invasive CSCC who underwent curative\u2010intent surgical treatment. Exclusions included cases of lip CSCC, cases with prior HN cancer with associated regional disease, patients with a history of chemotherapy\/radiotherapy for other HN neoplasms, and recurrent primary tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Tumors were staged according to both the AJCC8 TNM staging system and the BWH tumor classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Local recurrence (LR), nodal recurrence (NR), distant recurrence (DR), and disease\u2010specific death (DSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 9852 excised tumors from 3168 patients were included. The 2 systems had comparable monotonicity and homogeneity. Significant differences could be observed in 5\u2010year cumulative incidence for DSD in both BWH and AJCC8, and also for LR in BWH. Higher T\u2010stages exhibited similar curves regarding NR and DR for both AJCC8 and BWH staging systems. Overall, we observed high specificity and NPV, low sensitivity and PPV, and moderately high c\u2010indices for both the BWH and AJCC8 staging systems in predicting the main outcomes for HNCSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>Current AJCC8 and BWH staging systems can accurately predict survival in HNCSCC, although there are still important characteristics to be addressed in future staging systems for better stratification according to the other main outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28259","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T08:49:29Z","timestamp":1753433369000},"page":"3385-3393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Validation of Current Staging Systems in\n                    <scp>HNCSCC<\/scp>\n                    : A Multinational Cohort Study"],"prefix":"10.1002","volume":"47","author":[{"given":"F\u00e1bio Murad\u00e1s","family":"Girardi","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery Ana Nery Hospital  Santa Cruz do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian Petersen","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Dentistry School of Dentistry, S\u00e3o Paulo University (FOUSP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian David Cardona","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Dermatology Complejo Asistencial Universitario de Salamanca  Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Wysong","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina A.","family":"Ran","sequence":"additional","affiliation":[{"name":"Department of Dermatology Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5655-9792","authenticated-orcid":false,"given":"Emily E.","family":"Granger","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo A.","family":"Koyfman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison T.","family":"Vidimos","sequence":"additional","affiliation":[{"name":"Department of Dermatology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Ohio State University Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-1150","authenticated-orcid":false,"given":"Kathryn T.","family":"Shahwan","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Ohio State University Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey E.","family":"Hirotsu","sequence":"additional","affiliation":[{"name":"Stanford School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Carucci","sequence":"additional","affiliation":[{"name":"Department of Dermatology New York University School of Medicine  New York New York 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