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Staging is critically important for establishing cancer prognosis and treatment algorithms. The American Joint Commission on Cancer (AJCC) initiated staging systems for Merkel cell carcinoma and cutaneous squamous cell carcinoma (cSCC) because of their potential to metastasize. This “TNM” staging scheme synthesizes characteristics of the primary tumor (T), lymph nodes (N), and metastasis (M) to determine stage. This report from the cSCC staging committee focuses on T characteristics, as most cSCCs present as small primary tumors, and briefly discusses changes in N and M grading. (Changes to N criteria will be described elsewhere. Penile, vulvar, and eyelid SCC are staged separately.)
The new T grading system establishes clinical size >2 cm a…