Does the new staging system proposed for mycosis fungoides and Sézary syndrome provide reliable agreement for T1 and T2 disease?

Dermatology. 2015;230(1):40-5. doi: 10.1159/000366196. Epub 2014 Nov 27.

Abstract

Background: Patch or plaque stages in mycosis fungoides (MF) have different prognoses. The recent staging system proposed for MF discriminates between patches and plaques based upon clinical features.

Objective: To estimate interdermatologist agreement on the morphological evaluation of MF lesions.

Methods: Twenty-four patients with MF were enrolled. Two dermatologists evaluated every lesion face to face and independently with respect to the patch-plaque status. Cohen's κ was used to determine the rate of agreement.

Results: Agreement was 67% with respect to the patch or plaque status [95% confidence interval (CI) = 49-85%; p < 0.001]. Current systemic treatment (56%; p = 0.01) was associated with lower agreement. Younger age at diagnosis [odds ratio (OR) 1.03 (95% CI 1.02-1.05)], younger age at enrolment [OR 1.03 (95% CI 1.02-1.04)] and time on systemic treatment [OR 1.02 (95% CI 1.01-1.04)] were independent risk factors for disagreement (p < 0.001).

Conclusion: The new system for MF staging carries a significant risk of disagreement regarding patch and plaque subsets.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides / pathology*
  • Neoplasm Staging / methods*
  • Prognosis
  • Sezary Syndrome / pathology*
  • Skin Neoplasms / pathology*