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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Invasi&#243;n perineural&#58; compromiso de nervios de cualquier grosor localizados bajo la dermis&#44; de nervios de<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro en dermis o evidencia cl&#237;nica o radiol&#243;gica de afectaci&#243;n neural&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">AJCC&#59; American Joint Committee on Cancer&#59; FR&#58; factores de riesgo&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AJCC 7</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AJCC 8<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estadificaci&#243;n de Breuninger<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#62; 2 cm&#60;<span class="elsevierStyleHsp" style=""></span>2 FR<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Tumor &#60;<span class="elsevierStyleHsp" style=""></span>2 cm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Estadio cl&#237;nico &#40;Tc&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Bajo riesgo&#58; tumor<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>2 cmAlto riesgo&#58; tumor<span class="elsevierStyleHsp" style=""></span>&#62; 2 cm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 cm&#8805;<span class="elsevierStyleHsp" style=""></span>2 FR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm y &#60;<span class="elsevierStyleHsp" style=""></span>4 cm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Estadio patol&#243;gico &#40;Tp&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Sin riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>2mmBajo riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#62; 2<span class="elsevierStyleHsp" style=""></span>mm y<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6 mmAlto riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#62; 6 mm<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Invasi&#243;n de &#243;rbita&#44; maxilar superior&#44; mand&#237;bula o hueso temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm o invasi&#243;n profunda&#44; invasi&#243;n perineural<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> o erosi&#243;n &#243;sea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Factores de riesgo asociados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Inmunosupresi&#243;nSubtipo desmopl&#225;sico o pobremente diferenciadoLocalizaci&#243;n en oreja&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Invasi&#243;n de base de cr&#225;neo&#44; esqueleto o invasi&#243;n perineural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T4a invasi&#243;n &#243;sea cortical o de m&#233;dula &#243;seaT4b Invasi&#243;n de base del cr&#225;neo o del foramen oval&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">La AJCC 8 solo considera tumores cut&#225;neos en cabeza y cuello&#44; excluyendo los localizados en el p&#225;rpado&#46;</p>"
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              "identificador" => "tblfn0010"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Factores de riesgo de la AJCC 7&#58; espesor<span class="elsevierStyleHsp" style=""></span>&#62; 2<span class="elsevierStyleHsp" style=""></span>mm&#44; pobre grado de diferenciaci&#243;n&#44; infiltraci&#243;n perineural&#44; afectaci&#243;n de oreja o labio inferior&#44; nivel <span class="elsevierStyleSmallCaps">iv</span>-<span class="elsevierStyleSmallCaps">v</span> de invasi&#243;n de Clark&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Invasi&#243;n profunda&#58; invasi&#243;n por debajo del tejido celular subcut&#225;neo&#44; grosor tumoral<span class="elsevierStyleHsp" style=""></span>&#62; 6<span class="elsevierStyleHsp" style=""></span>mm &#40;medido desde la granulosa del epitelio de piel normal adyacente a la base del tumor&#41;&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Riesgo de met&#225;stasis&#58; sin riesgo&#58; 0&#37;&#44; bajo riesgo&#58; 4&#37;&#44; alto riesgo 16&#37;&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">Fuente para riesgo de met&#225;stasis&#58; Breuninger et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46;</p>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de diversas estadificaciones del carcinoma cut&#225;neo de c&#233;lulas escamosas</p>"
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FORO DE RESIDENTES
FR - Estadificación del carcinoma cutáneo de células escamosas: desafíos e interrogantes
RF - Staging Cutaneous Squamous Cell Carcinoma: Challenges and Questions
D. Morgado-Carrascoa, X. Bosch-Amatea, X. Fustà-Novella, A. García-Herrerab,
Corresponding author
apgarcia@clinic.cat

Autor para correspondencia.
a Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
b Servicio de Patología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
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&#40;recurrencia local&#44; met&#225;stasis ganglionar y mortalidad espec&#237;fica&#41;&#46; La mayor&#237;a de los tumores eran T1 &#40;AJCC-7&#58; 66&#44;2&#37; y AJCC-8&#58; 76&#44;9&#37;&#41;&#44; tama&#241;o medio de 0&#44;8<span class="elsevierStyleHsp" style=""></span>cm&#44; el 59&#37; era bien diferenciado y el 7&#37; presentaba invasi&#243;n perineural&#46; Solo el 0&#44;3&#37; fue clasificado como T4 &#40;AJCC-7&#47;AJCC-8&#41;&#46; Al utilizar la AJCC-7&#44; la mayor&#237;a de ED &#40;83&#37;&#41; se observaron en los T1&#47;T2 y solo el 17&#37; en los T3&#47;T4&#46; En cambio&#44; la mayor&#237;a de ED &#40;70&#37;&#41; se concentraron en las clasificaciones avanzadas de la AJCC-8 &#40;T3-T4b&#41; y solo un 17&#37; en los T1-T2&#46; La mayor&#237;a de fallos de clasificaci&#243;n en la AJCC-8 se asociaron a tumores pobremente diferenciados&#46; Con base en estos resultados&#44; se concluy&#243; que la AJCC-8 presenta una mayor homogeneidad y monotonicidad que la AJCC-7 &#40;McNemar p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#46; Otro estudio de orden poblacional conducido por Roscher et al&#46; eval&#250;o la validez y utilidad de 4 sistemas de estadificaci&#243;n &#40;AJCC-7&#44; AJCC-8&#44; estadificaci&#243;n de Breuninger &#91;EB&#93; y la clasificaci&#243;n del Hospital de Brigham &#91;CHB&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46; Se incluyeron 2<span class="elsevierStyleHsp" style=""></span>grupos&#58; 103 pacientes con met&#225;stasis &#40;58&#37; hombres&#44; edad media&#58; 72&#44;7 a&#241;os&#41; y 81 individuos sin met&#225;stasis aleatorizados y apareados por edad y sexo&#46; Los 4 sistemas de estadificaci&#243;n discriminaron pobre o moderadamente a los pacientes con met&#225;stasis&#46; La AJCC-8 fue superior a la AJCC-7&#44; pero inferior a CHB y EB&#46; En la CHB y la EB&#44; el riesgo de met&#225;stasis fue significativamente superior a mayor estadio tumoral&#46; La EB present&#243; la mejor validaci&#243;n externa&#44; con una alta sensibilidad &#40;77&#44;3&#37;&#41;&#44; especificidad &#40;75&#37;&#41; y correcta clasificaci&#243;n tumoral &#40;76&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46; La EB es una clasificaci&#243;n simple basada en el tama&#241;o&#44; el grosor tumoral y 3 factores de riesgo asociados&#44; que incluyen el subtipo desmopl&#225;sico y los tumores pobremente diferenciados<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Un sistema de estadificaci&#243;n deber&#237;a ser simple&#44; reproducible&#44; aportar informaci&#243;n relevante sobre el pron&#243;stico y orientar la terapia&#46; La AJCC-8 parece ser superior a la AJCC-7&#44; pero es discutible la exclusi&#243;n de factores como el grado de diferenciaci&#243;n histol&#243;gica&#44; que podr&#237;an explicar la superioridad de otras clasificaciones como la CHB y la EB&#44; que incluyen este par&#225;metro&#46;</p></span>"
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          "palabras" => array:5 [
            0 => "Carcinoma escamoso"
            1 => "AJCC 7"
            2 => "AJCC 8"
            3 => "Estadificaci&#243;n del c&#225;ncer cut&#225;neo"
            4 => "C&#225;ncer cut&#225;neo"
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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Invasi&#243;n perineural&#58; compromiso de nervios de cualquier grosor localizados bajo la dermis&#44; de nervios de<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro en dermis o evidencia cl&#237;nica o radiol&#243;gica de afectaci&#243;n neural&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">AJCC&#59; American Joint Committee on Cancer&#59; FR&#58; factores de riesgo&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AJCC 7</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AJCC 8<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estadificaci&#243;n de Breuninger<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estadio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#62; 2 cm&#60;<span class="elsevierStyleHsp" style=""></span>2 FR<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor &#60;<span class="elsevierStyleHsp" style=""></span>2 cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Estadio cl&#237;nico &#40;Tc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Bajo riesgo&#58; tumor<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>2 cmAlto riesgo&#58; tumor<span class="elsevierStyleHsp" style=""></span>&#62; 2 cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 cm&#8805;<span class="elsevierStyleHsp" style=""></span>2 FR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm y &#60;<span class="elsevierStyleHsp" style=""></span>4 cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Estadio patol&#243;gico &#40;Tp&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Sin riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>2mmBajo riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#62; 2<span class="elsevierStyleHsp" style=""></span>mm y<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6 mmAlto riesgo&#58; grosor<span class="elsevierStyleHsp" style=""></span>&#62; 6 mm<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Invasi&#243;n de &#243;rbita&#44; maxilar superior&#44; mand&#237;bula o hueso temporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Tumor<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm o invasi&#243;n profunda&#44; invasi&#243;n perineural<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> o erosi&#243;n &#243;sea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Factores de riesgo asociados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Inmunosupresi&#243;nSubtipo desmopl&#225;sico o pobremente diferenciadoLocalizaci&#243;n en oreja&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Invasi&#243;n de base de cr&#225;neo&#44; esqueleto o invasi&#243;n perineural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">T4a invasi&#243;n &#243;sea cortical o de m&#233;dula &#243;seaT4b Invasi&#243;n de base del cr&#225;neo o del foramen oval&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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              "identificador" => "tblfn0005"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">La AJCC 8 solo considera tumores cut&#225;neos en cabeza y cuello&#44; excluyendo los localizados en el p&#225;rpado&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Factores de riesgo de la AJCC 7&#58; espesor<span class="elsevierStyleHsp" style=""></span>&#62; 2<span class="elsevierStyleHsp" style=""></span>mm&#44; pobre grado de diferenciaci&#243;n&#44; infiltraci&#243;n perineural&#44; afectaci&#243;n de oreja o labio inferior&#44; nivel <span class="elsevierStyleSmallCaps">iv</span>-<span class="elsevierStyleSmallCaps">v</span> de invasi&#243;n de Clark&#46;</p>"
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              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Invasi&#243;n profunda&#58; invasi&#243;n por debajo del tejido celular subcut&#225;neo&#44; grosor tumoral<span class="elsevierStyleHsp" style=""></span>&#62; 6<span class="elsevierStyleHsp" style=""></span>mm &#40;medido desde la granulosa del epitelio de piel normal adyacente a la base del tumor&#41;&#46;</p>"
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              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Riesgo de met&#225;stasis&#58; sin riesgo&#58; 0&#37;&#44; bajo riesgo&#58; 4&#37;&#44; alto riesgo 16&#37;&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">Fuente para riesgo de met&#225;stasis&#58; Breuninger et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46;</p>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de diversas estadificaciones del carcinoma cut&#225;neo de c&#233;lulas escamosas</p>"
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                      "titulo" => "AJCC Cancer Staging Manual"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;B&#46; Amin"
                            1 => "S&#46; Edge"
                            2 => "F&#46; Greene"
                            3 => "D&#46;R&#46; Byrd"
                            4 => "R&#46;K&#46; Brookland"
                            5 => "M&#46;K&#46; Washington"
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                        "editorial" => "New York&#58; Springer International Publishing&#59;"
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                    0 => array:2 [
                      "titulo" => "Novel additions to the AJCC&#39;s New Staging Systems for Skin Cancer"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Ca&#241;ueto"
                            1 => "C&#46; Rom&#225;n-Curto"
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                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2017.05.012"
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                        "tituloSerie" => "Actas Dermosifiliogr&#46;"
                        "fecha" => "2017"
                        "volumen" => "108"
                        "paginaInicial" => "818"
                        "paginaFinal" => "826"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28732551"
                            "web" => "Medline"
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Article information
ISSN: 00017310
Original language: Spanish
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