Evidence map›Paper›PMID 33352413›Full record

ArticleEuropean journal of cancer (Oxford, England : 1990)2021

Integrating depth of invasion in T classification improves the prognostic performance of the American Joint Committee on Cancer primary tumor staging system for cutaneous squamous cell carcinoma of the head and neck.

Moran Amit, Chuan Liu, Frederico-Omar Netto Gleber, Sameer Kini, Samantha Tam, Avi Benov, Mohamed Aashiq, Adel K El-Naggar, Amy C Moreno, David I Rosenthal and 11 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of cancer (Oxford, England : 1990), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Prediction and Prognostication of Peripheral Blood Biomarkers in Head and Neck Cutaneous Squamous Cell Carcinoma.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Article
  2. Article
  3. Value of pre-treatmentEuropean journal of radiology open · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 3 institutions in 2 countries.

Moran AmitDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: Mamit@mdanderson.org.
Chuan LiuDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Frederico-Omar Netto GleberDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Sameer KiniDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Samantha TamDepartment of Otolaryngology - Head and Neck Surgery, Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA.
Avi BenovIsrael Defense Forces, Medical Corps, Tel Hasomer, Ramat Gan, Israel.
Mohamed AashiqDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Adel K El-NaggarDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Amy C MorenoDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
David I RosenthalDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Bonnie S GlissonDepartment of Thoracic and Head/Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Renata FerrarottoDepartment of Thoracic and Head/Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Michael K WongDepartment of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Michael R MigdenDepartment of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Guojun LiDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Anshu KhannaDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ryan P GoepfertDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Priyadharsini NagarajanDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Randal S WeberDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jeffrey N MyersDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Neil D GrossDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: NGross@mdanderson.org.
The University of Texas MD Anderson Cancer Center · USHenry Ford Health System · USIsrael Defense Forces Medical Corps · IL

Funding

Defining the Role of Tumor-Neutral Crosstalk in head and Neck Cancer Progression and Treatment ResistanceR37CA242006 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI AMIT, MORAN · 2020 to 2025
$3.4M
NCI NIH HHS R37 CA242006
6 · The paper itself

Abstract

backgroundThe last revision of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual included a specific system for cutaneous squamous cell carcinoma (CSCC) of the head and neck. Here, we assessed the prognostic performance of six candidate modified T-classification models in head and neck CSCC patients.

methodsAnalysis of 916 patients with head and neck CSCC given treatment with curative intent at The University of Texas MD Anderson Cancer Center between 1995 and 2019 was performed. The main outcome was disease-specific survival (DSS), and the impact of depth of invasion (DOI) was analyzed using multivariable regression models. Candidate models were developed using the optimal DOI cut points for each AJCC T classification based on goodness of fit of the model and the simplicity of the model. Staging systems were compared using Harrell's concordance index.

resultsMedian age was 70 years (range, 19-97years) and median follow-up time of 22 months (range, 1-250months). The median DOI was 6.0 mm (range, 0.1-70.0 mm). The five-year DSS rate was 80.7% (95%CI, 77.4-83.7%). We found significant association between DOI (hazard ratio, 1.21 [95%CI: 1.01-1.43]) and DSS on multivariable analysis. Based on a low Akaike information criterion score, improvement in the concordance index, and Kaplan-Meier curves, model 6 surpassed the AJCC staging system.

conclusionsIncorporation of DOI in the current AJCC staging system improves discrimination of T classifications in head and neck CSCC patients. LAY SUMMARY: The current staging system for head and neck cutaneous squamous cell carcinoma demonstrates wide prognostic variability and provides suboptimal risk stratification. Incorporation of depth of invasion in the T-classification system improves risk prediction and patient counseling. PRECIS: We propose improved head and neck cutaneous squamous cell carcinoma T staging that will include depth of invasion and should be considered in future versions of the American Joint Committee on Cancer after external validation.

Indexed as

AdultAgedAged, 80 and overFemaleFollow-Up StudiesHead and Neck NeoplasmsHumansMaleMiddle AgedNeoplasm InvasivenessPrognosisRetrospective StudiesSkin NeoplasmsSquamous Cell Carcinoma of Head and NeckYoung AdultAJCCPrognosisSkinSquamous cell carcinomaStagingSurvival

Identifiers

PMID33352413
PMCPMC12121349
OpenAlexW3113456494

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.