Dermatológia pre prax 4/2013
Squamous cell carcinoma of the skin – evaluation of the histopathological findings and a comparision of the TNM classifications in a group of diagnosed cases
Background: In the latest 7.th of the TNM classification of non-melanoma skin cancers there are different evaluation criteria between UICC (Union for International Cancer Control) and AJCC (American Joint Committee on Cancer) classification scheme. AJCC system is more complex and also includes following additional risk parameters: location on the ear and lip, tumor thickness, Clark level, perineural invasion and degree of tumor differentiation. Aim: In our work we retrospectively evaluated histological findings in a set of invasive cutaneous squamous cell carcinomas (SCC) and compared the changes in proportion of the individual pT stages between these two classification schemes. Material and methods: Study group consisted of 21 primary invasive SCCs of the skin, in which all basic histomorphological parameters were able to assess. Results: According to UICC TNM classification, 17 SCCs (80.9 %) corresponded to the stage pT1, 3 SCCs (14.3 %) to the stage pT2 and one (4.8 %) SCC to the stage pT3. According to AJCC TNM classification, 3 SCCs (14.3 %) corresponded to the stage pT1 and 18 SCCs (85.7 %) to the stage pT2. A comparision of both separate systems revealed, that identical pT stage had remained in 6 tumors (28.5 %), in 14 tumors (66.7 %) it had been „increasing“ of stage pT1 (according to UICC) to stage pT2 (according to AJCC) and in one case (4.8 %) it had been „decreasing“ of stage pT3 (according to UICC) to stage pT2 (according to AJCC). Conclusion: American TNM classification system is more complex and requires more detailed histomorphology assessment. Its advantage is a selection of those cancers, which correspond to the lowest stage pT1 on the basis of its size, however, a presence of at least 2 risk morphological parameters moves them into the higher cathegory pT2, which is expected to have a worse prognosis.
Keywords: TNM classification, squamous cell carcinoma of the skin.
