Refining Field Cancerization: An Institutional Cohort Analysis of Patient Characteristics in a Validation Cohort.

BACKGROUND

Field cancerization is poorly defined in dermatology. The author group previously proposed and applied a classification system in an original cohort to risk-stratify patients with field cancerization.

OBJECTIVE

Apply the authors' classification system within a validation cohort.

METHODS

Patients with keratinocyte carcinoma history completed a survey regarding demographic information, medical history, and chemoprevention use. Patients were assigned a field cancerization class, and differences between validation and original cohorts were assessed.

RESULTS

A total of 363 patients were enrolled (mean age 67.4; 61.7% male). After comparing validation and original cohorts, there were differences in age between class II ( p = .02) and class IVb ( p = .047), and differences in chemoprevention use in class III ( p = .04). Similar to the original cohort, the validation cohort was associated with increases in total number of skin cancers in the last year ( p < .001), 5 years ( p < .001), lifetime ( p < .001), years since first skin cancer ( p < .001), and chemoprevention use ( p < .001). In the validation cohort, there were increases in age ( p = .03) and immunocompromised status ( p = .04) with increasing class, which were not observed in the original cohort.

CONCLUSION

Differences among field cancerization classes were similar in a validation cohort, further highlighting the importance of class-specific treatment and management.