Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia II. Perineural invasion

Leibovitch, Igal; Huilgol, Shyamala C.; Selva, Dinesh; Hill, Dudley; Richards, Shawn; Paver, Robert

doi:10.1016/j.jaad.2005.03.048

Cited by 162 publications

(166 citation statements)

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“…10,14,16,20,21,24,25 Patients who underwent MMS with or without XRT achieved superior local control rates of 92% to 100%. 13,15,18,24 Early studies, which consisted almost entirely of patients who were symptomatic or who had imaging-positive disease (ie, clinical PNI) demonstrated local control rates at the lower end of the spectrum, ranging from 38% to 53%, 14,21,24 with 1 reported 5-year survival rate of 33%. 21 The results reported by Ampil et al, who performed aggressive surgery with or without XRT for patients with extensive PNI, differed somewhat from the other studies, with a local control rate of 66.7% and 100% 5-and 10-year disease-free survival rates.…”

Section: Resultsmentioning

confidence: 99%

“…Because of the disproportionate power of a meta-analysis, the findings from the study by Rowe et al (ie, 53% local control with standard excision with or without XRT and 100% local control with MMS with or without XRT) are more precise and, thus, carry more weight compared with the range of local control rates described above. The difference between the local control rates achieved with MMS versus standard excision with or without XRT for SCC with PNI is striking, with reported local control rates from 92% to 100% for MMS 13,15,18,24 compared with control rates from 38% to 87% for standard excision. 10,14,16,20,21,24,25 Because MMS examines the entire peripheral and deep margin of the surgical specimen, it provides the greatest likelihood of complete tumor excision.…”

Section: Discussionmentioning

confidence: 98%

“…5,[9][10][11] Risk factors for PNI in SCC include male sex, tumor size >2 cm, midfacial tumor location, recurrent tumor, less well differentiated histologic subtypes, and significant subclinical extension. [11][12][13][14][15][16] Patients with SCC who have risk factors for PNI require an organized approach to their evaluation, because early detection of PNI maximizes the chance of effective treatment. Pretreatment evaluation of these high-risk patients consists of a thorough history and physical examination.…”

Section: Methodsmentioning

confidence: 99%

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What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Han

Ratner

2007

Cancer

144

108

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BACKGROUND.Perineural invasion (PNI) in cutaneous squamous cell carcinoma (SCC) is infrequent, occurring in 2.5% to 14% of patients, but it is important prognostically, because it carries an increased risk of recurrence and metastasis. Although both excision and Mohs micrographic surgery (MMS) are used to treat SCC with PNI, postoperative radiation therapy (XRT) often is recommended to minimize the risk of recurrence. To date, the effectiveness of adjuvant XRT in this setting has not been determined definitively.METHODS.The authors evaluated the effectiveness of adjuvant XRT in treating SCC with PNI by performing a thorough literature review.RESULTS.For SCC with PNI, the local control rate after MMS with or without XRT was from 92% to 100% compared with a control rate from 38% to 100% after standard excision with or without XRT. A better prognosis was associated with negative pretreatment magnetic resonance imaging or computed tomography findings than with positive radiographic evidence of PNI. Primary SCC with PNI was associated with better local control than recurrent SCC with PNI. When treatment outcomes were stratified by PNI type, SCC with microscopic PNI and SCC with extensive PNI had local control rates from 78% to 87% and from 50% to 55%, respectively. Adjuvant XRT was associated in selected patients with 100% local control.CONCLUSIONS.Few studies addressed the effectiveness of adjuvant XRT in patients who have SCC with PNI. Although XRT has been established as an adjuvant treatment for selected patients, the extent of nerve involvement by tumor, particularly in the setting of other high‐risk features, may be helpful in defining its role. In the future, a multicentered, prospective, randomized clinical trial will be needed to assess the true efficacy of adjuvant XRT in the treatment of patients with SCC and PNI. Cancer 2007 © 2007 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

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What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Han

Ratner

2007

Cancer

144

108

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“…Although based on retrospective studies, PNI showed a higher association with tumors in the face, lower degree of differentiation, tumors larger than 2 cm and recurrent tumors (Leibovitch, Huilgol et al 2005). There is evidence of an increased incidence of cervical lymphadenopathy and distant metastasis, along with significantly reduced survival in patients with tumors that showed PNI (Farasat, Yu et al 2011).…”

Section: Advanced Tumors: Characteristics Of Primary Tumormentioning

confidence: 98%

Advanced Squamous Cell Carcinoma of the Skin

Vazquez¹,

Serrano²,

Capuzzo³

2012

Squamous Cell Carcinoma

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“…Poorer prognosis as poor host response increases likelihood of recurrence and metastasis (Day and Rowe, 1993;Mohs and Snow, 1985;Mohs, 1980;Leibovitch et al, 2005a) …”

Section: Histologymentioning

confidence: 99%

Textbook of Plastic and Reconstructive Surgery

Butler¹,

Ghali²,

Kalaskar³

2016

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A CIP catalogue record for this book is available from The British Library.This book is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. The user is advised to always check the product information and clinical procedures with the most up-to-date published product information and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or misuse or misapplication of material in this work.ISBN: 978-1-910634-37-0 (Hbk.) ISBN: 978-1-910634-38-7 (Pbk.) ISBN: 978-1-910634-39-4 (PDF) ISBN: 978-1-910634-40-0 (epub) ISBN: 978-1-910634-41-7 (mobi)

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Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia II. Perineural invasion

Cited by 162 publications

References 21 publications

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Advanced Squamous Cell Carcinoma of the Skin

Textbook of Plastic and Reconstructive Surgery

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