Decision making
Can a clinicopathologic model predict cSCC metastasis risk?
Open access · cc by · source: Europe PMC
A Dutch-developed, England-validated model (C-index ~0.80–0.84) gives personalised absolute metastatic risk for cutaneous squamous cell carcinoma better than current staging for key decisions.
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Can a clinicopathologic model predict cSCC metastasis risk?
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Development cohort n=390; validation n=696.
The model was developed on the Dutch cohort (n = 390) using a weighted Cox regression model with backward selection and validated on the English cohort (n = 696).
Validation C-index 0.84; calibration slope 0.96.
a C-index of 0.84 (95% CI 0.81–0.87) in the validation cohort. Model predictions were well-calibrated: the calibration slope was 0.96 (95% CI 0.76–1.16) in the validation cohort.
Key findings
Optimism-corrected C-index 0.80 in development and 0.84 in validation; calibration slope 0.96; improved decision-curve net benefit for follow-up/adjuvant thresholds. Released as an online calculator.
Methodology
Built nested case–control cohorts from nationwide Dutch (2007–2008) and English (2013–2015) cSCC data, developed a weighted Cox clinico-pathological model (8/11 variables) on n=390, validated on n=696, and compared discrimination/calibration/net benefit with BWH and AJCC staging.
Limitations
Still needs prospective decision-impact studies in other populations; nested case–control design estimates relative/absolute risk under sampling weights, not a simple consecutive series prevalence.
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