Factors Predictive of Recurrence and Death From Cutaneous Squamous Cell Carcinoma

Abstract

Cutaneous squamous cell carcinoma carries a low but significant risk of metastasis and death. In this study, patients with CSCC had a 3.7% risk of metastasis and 2.1% risk of disease-specific death. Tumor diameter of at least 2 cm, invasion beyond fat, poor differentiation, perineural invasion, and ear, temple, or anogenital location were risk factors associated with poor outcomes. Accurate risk estimation of outcomes from population-based data and clinical trials proving the utility of disease-staging modalities and adjuvant therapy is needed.

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…However, deaths that were attributable to SCC were rare, with 2.7% of our total population dying as a result of their disease. This was similar to the 1.5% and 2.1% figures reported in other studies 569,693 and slightly less than the 4.1% we found on pooled analysis of case series of surgical excision, which may be partly explained by possible misrecording of deaths as being due to SCC in what were mostly retrospective studies. Inaccurate death certification has been recognised as a particular problem for NMSC, so these data should be interpreted cautiously.…”

“…This was similar to the 5.4% local recurrence seen after conventional excision which we recently reported in our systematic review and pooled analysis of case series of treatments for SCC 536 and the 4.6% local recurrence reported in a large 10-year prospective cohort study of 985 patients. 693 Metastasis to regional lymph nodes occurred in 3.3% of excised SCCs. This was comparable with the 1.9-2.6% figure for nodal metastasis recently reported over a 10-year study period in a retrospective study of 6164 patients 666 and with other studies in which nodal metastases of 3.7% and 4% have been reported 569,693 and the 4.4% after surgical excision in our pooled analysis of case series.…”

“…693 Metastasis to regional lymph nodes occurred in 3.3% of excised SCCs. This was comparable with the 1.9-2.6% figure for nodal metastasis recently reported over a 10-year study period in a retrospective study of 6164 patients 666 and with other studies in which nodal metastases of 3.7% and 4% have been reported 569,693 and the 4.4% after surgical excision in our pooled analysis of case series. 536 Overall mortality from any cause was high with 43.8% of the study population having died over the 5 years, although this is not entirely surprising given the advanced age of the group.…”

Non-melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

“…This system has the virtue of simplicity, since it categorizes lesions into only 2 categories of recurrence risk-low and high-and it relies on observable clinical or histologic features of the lesion or patient. [13][14][15][16][17] As shown below, risk factors for tumour metastasis almost completely overlap substantially with recurrence risk factors.…”

High-risk Cutaneous Squamous Cell Carcinoma

“…10 Notably, recent meta-analysis has found no independent predicted association between cSCC of the lips and ears with recurrence, in contrast with previous studies. 17,40 Immunosuppression is associated with higher rates of cSCC. 41,42 Solid organ transplant recipients, such as renal transplant patients, demonstrate a 100-fold increased risk for invasive cSCC compared with the general population.…”