Prevalence of poor outcomes in cutaneous squamous cell carcinoma by AJCC and BWH tumor stages: A systematic review and meta-analysis.

Background: Cutaneous squamous cell carcinoma (cSCC) generally has a favorable prognosis, but some patients experience poor outcomes (POs).

Objective: To evaluate the prevalence of POs in cSCC patients by American Joint Committee on Cancer (AJCC) and Brigham and Women's Hospital (BWH) tumor stages.

Methods: A systematic review and meta-analysis were conducted using PubMed, Medline, and SCOPUS on November 15, 2023. Studies reporting POs by AJCC or BWH stages in cSCC patients were included. Meta-analysis was performed using a random effects model.

Results: Out of 3364 articles, 30 studies were included. For AJCC 8, local recurrence rates were 3.6% (T1), 5.4% (T2), 11.1% (T3), and 21.5% (T4). Nodal metastasis (NM) rates were 1.5% (T1), 9.8% (T2), 19.6% (T3), and 47.4% (T4). For BWH stages, local recurrence rates were 2.7% (T1), 7.5% (T2a), 15.7% (T2b), and 33.5% (T3). NM rates were 0.7% (T1), 3.9% (T2a), 16.7% (T2b), and 40.9% (T3).

Conclusions: Heterogeneity in study designs and reporting standards may impact findings. Some stages had limited data, leading to wider confidence intervals. Conclusions: This meta-analysis highlights prognostic differences between AJCC 7, AJCC 8, and BWH staging systems, with BWH providing nuanced stratification for NM. Personalized risk assessment is essential in managing cSCC.