Immunocompromised patients with metastatic cutaneous nodal squamous cell carcinoma of the head and neck: Poor outcome unrelated to the index lesion

Lam, Johnson K.S.; Sundaresan, Puma; Gebski, Val; Veness, Michael J.

doi:10.1002/hed.25069

Cited by 24 publications

(22 citation statements)

References 24 publications

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“…Other studies have shown that IS is a risk factor for cSCC distant metastasis and can lower tumor specific survival . A prospective cohort study comparing immunocompromised patients with nodal involvement to the immunocompetent patients also demonstrated worse relapse‐free survival and overall survival in the immunocompromised group . We did not find clear evidence that other high‐risk features were associated with recurrence as has been suggested by other studies .…”

Section: Discussioncontrasting

confidence: 70%

Outcomes following radiation for cutaneous squamous cell carcinoma of the head and neck: Associations between immune suppression and recurrence

et al. 2019

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Background: Data evaluating outcomes and patterns of recurrence following radiation therapy (RT) for cutaneous squamous cell carcinoma (cSCC) of the head and neck are limited. Methods: We performed a retrospective analysis of 111 head and neck cSCC patients treated with RT at 4 affiliated institutions. Results: With median follow-up of 7 months, there were 29 (26%) recurrences, 73% of which were nodal (n = 21). Immunosuppression (IS) was the only factor associated with recurrence (47% in IS, 22% in non-IS, P = .04), and also with time to recurrence in multivariate analysis (HR 5.5; P = .03). No factors were associated with recurrence among patients who received definitive RT. The majority of patients who recurred were salvaged with surgery (n = 20, 69%). Conclusion: In a cohort of cSCC treated with radiotherapy, there was an association between IS and increased failure risk. The majority of failures were salvaged surgically.

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Section: Discussioncontrasting

confidence: 70%

Outcomes following radiation for cutaneous squamous cell carcinoma of the head and neck: Associations between immune suppression and recurrence

et al. 2019

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“…Several studies have shown worse outcomes for cSCC in immunosuppressed patients compared to immunocompetent patients [39,40]. In immunosuppressed patients, locoregional recurrence was more common [39], whereas the risk of metastatic cSCC at least doubled [25] and outcomes for advanced disease were significantly worse [41]. Mortality rates of 494 per 100,000 were reported for the U.S. transplant population [42]; higher risk of recurrence, nodal metastasis and death is also reported in CLL [43e45] and survival after nodal disease in immunosuppressed individuals is significantly reduced [41].…”

Section: Prognosismentioning

confidence: 99%

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention

Stratigos

Garbe²,

Dessinioti

et al. 2020

European Journal of Cancer

173

233

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“…[35][36][37] Cutaneous SCC is the most common cancer in SOTRs, and some SOTRs develop multiple SCCs associated with poor treatment outcomes. 36,38,39 A viral cause for cutaneous SCC has been considered, with some HPV types assessed as candidates, but evidence remains inconclusive. 40,41 UVR is the major causative factor for skin cancers.…”

Section: Engelsmentioning

confidence: 99%

“…Results for cancers for which checkpoint inhibitor therapy has been approved by the US Food and Drug Administration (see Supplemental Table S3) are shown as triangles and for other cancers as circles. 35,38,39 Nonetheless, cancer aggressiveness is difficult to define, and subtle differences may readily be missed.…”

Section: Incidence Of Certain Other Major Cancers Is Moderately Elevamentioning

confidence: 99%

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Epidemiologic perspectives on immunosuppressed populations and the immunosurveillance and immunocontainment of cancer

Engels

2019

American Journal of Transplantation

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The advent in the last several years of effective immunotherapy for cancer has renewed interest in the role of the immune system in controlling cancer. The idea that the immune system can help control cancer has a long history. Solid organ transplant recipients (SOTRs) as well as human immunodeficiency virus (HIV)-infected people are affected by cell-mediated immune dysfunction. Epidemiologic studies of these populations reveal a pattern characterized by a strongly increased incidence of virus-related cancers (eg, Kaposi sarcoma, non-Hodgkin lymphoma, and anogenital cancers). In addition, recent epidemiologic studies have evaluated cancer-specific mortality among SOTRs and HIV-infected people following a cancer diagnosis. For a wider range of cancers-not limited to those caused by viruses, and including melanoma and cancers of the colorectum, lung, and breast-these immunosuppressed cancer patients have higher cancer-specific mortality than other cancer patients. This latter group of cancers somewhat mirrors those for which immunotherapy with checkpoint inhibitors is approved. These epidemiologic observations suggest that there are 2 distinct immune selection processes in humans: immunosurveillance directed against premalignant cells before cancer diagnosis (most relevant for preventing virus-related cancers), and "immunocontainment" directed against established cancers. These processes thus appear relevant for different groups of malignancies and may have different mechanisms. K E Y W O R D Scancer/malignancy/neoplasia, cancer/malignancy/neoplasia: registry/incidence, cancer/ malignancy/neoplasia: risk factors, clinical research/practice, epidemiology, hematology/ oncology, immune deficiency, immunosuppression/immune modulation, translational research/science | INTRODUC TI ONThe advent in the last several years of effective immunotherapy for cancer has renewed interest in the role of the immune system in controlling cancer. 1-3 The field of cancer immunotherapy has long drawn support from the observation that immunosuppressed individuals, including solid organ transplant recipients (SOTRs), have an elevated risk of developing cancer. 2 In this Personal

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Immunocompromised patients with metastatic cutaneous nodal squamous cell carcinoma of the head and neck: Poor outcome unrelated to the index lesion

Abstract: No significant difference was identified in the primary cutaneous SCC between the immunocompetent and immunocompromised patients. Immunosuppression predicted worse outcome.

Cited by 24 publications

References 24 publications

Outcomes following radiation for cutaneous squamous cell carcinoma of the head and neck: Associations between immune suppression and recurrence

Outcomes following radiation for cutaneous squamous cell carcinoma of the head and neck: Associations between immune suppression and recurrence

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention

Epidemiologic perspectives on immunosuppressed populations and the immunosurveillance and immunocontainment of cancer

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