In-Transit Metastasis From Squamous Cell Carcinoma

H.Y., Joyce; Wu, Albert Y.; Veness, Michael J.; Estall, Vanessa; Hong, Angela; Borg, Martin; James, Craig; Ibbetson, Jan; Ooi, Colin; Weightman, Warren; McColl, Ian; Hamann, Ian; Grieve, Noel; Ozluer, Selim; Salmon, P. R.; Nikitins, M. D.; Caplash, Yugesh; Marshall, Nicholas J.; Edwards, Timothy L.; Patterson, Ian; Selva, Dinesh; Huilgol, Shyamala C.

doi:10.1097/dss.0000000000000864

Cited by 27 publications

(40 citation statements)

References 30 publications

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“…In our patients with in‐transit metastasis, the median time to locoregional recurrence was 0.5 months, the median time to OS was 5.5 months, and early locoregional recurrence within 6 months of completing radiation was fatal. This is consistent with the limited data that postulate the association of in‐transit metastasis with very poor survival …”

Section: Discussionsupporting

confidence: 92%

“…This is consistent with the limited data that postulate the association of in-transit metastasis with very poor survival. 5,6 In melanoma, a disease for which intralymphatic metastases are better characterized, in-transit metastasis was incorporated into the AJCC seventh edition nodal classification system as an intermediary between N2 and N3 disease. 7,8 In our cohort, 5 of 7 patients (71%) with in-transit metastasis were considered "node-negative" per the eighth edition staging criteria.…”

Section: Discussionmentioning

confidence: 99%

“…In‐transit metastasis, which is currently incorporated into the melanoma staging system, has been associated with increased mortality in cutaneous SCC. It is a rare and advanced phenomenon that is not addressed in the manual . In addition, several risk factors previously included in the AJCC seventh edition system are omitted in the eighth edition, including histologic differentiation and unfavorable location (eg, ear or lip).…”

Section: Introductionmentioning

confidence: 99%

“…It is a rare and advanced phenomenon that is not addressed in the manual. [5][6][7][8] In addition, several risk factors previously included in the AJCC seventh edition system are omitted in the eighth edition, including histologic differentiation and unfavorable location (eg, ear or lip).…”

Section: Introductionmentioning

confidence: 99%

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Major prognostic factors for recurrence and survival independent of the American Joint Committee on Cancer eighth edition staging system in patients with cutaneous squamous cell carcinoma treated with multimodality therapy

Lazar

Garsa

et al. 2018

Head & Neck

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Major prognostic factors for recurrence and survival independent of the American Joint Committee on Cancer eighth edition staging system in patients with cutaneous squamous cell carcinoma treated with multimodality therapy

Lazar

Garsa

et al. 2018

Head & Neck

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“…Satellite or in-transit metastases should be removed surgically if the number, size and location allow complete removal of the metastatic sites. According to a case series, adjuvant radiation therapy can be helpful in such cases [74]. For multiple unresectable metastases on the limbs, amputation used to be a common option; however, currently it is no longer performed as it has no proven impact on the prognosis and several local and systemic alternatives are available to prevent mutilation [74].…”

Section: Treatment For In-transit Metastasesmentioning

confidence: 99%

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Stratigos

Garbe²,

Dessinioti

et al. 2020

European Journal of Cancer

250

371

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Implications of Satellitosis or In-transit Metastasis in Cutaneous Squamous Cell Carcinoma

et al. 2022

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cell carcinoma and melanoma, satellitosis or in-transit metastasis (S-ITM) is not incorporated into the current cutaneous squamous cell carcinoma (CSCC) staging systems. It is important to determine if the clinical outcomes of S-ITM are relevant to prognosis for patients with CSCC.OBJECTIVES To evaluate the association of S-ITM with clinical outcomes in patients with CSCC and to determine its prognostic implications. DESIGN, SETTINGS, AND PARTICIPANTSA dual-institution (Cleveland Clinic and Brigham and Women's Hospital) database was queried for patients who were treated for CSCC in 2010 to 2020. Patients who were node-negative and had S-ITM-the presence of dermal lesions between the primary tumor and first-echelon lymphatic nodal basins at any point in the disease course-were identified. Subcohorts of patients with T3N0 tumors, T4N0 tumors (bone invasive), N1 to 3, and M1 disease were identified for comparison. The American Joint Committee on Cancer staging system was used to define cancer stages. Data were analyzed from January 15 to March 31, 2021. MAIN OUTCOMES AND MEASURESPairwise comparison of CSCC recurrence and disease-specific survival in patients with and without S-ITM was performed using Cox proportional hazard modeling. Kaplan-Meier and Fine-Gray competing risk methods were used to estimate disease-specific survival and CSCC recurrence, respectively. RESULTSIn a total of 518 patients with CSCC, S-ITM was present in 72 (13.9 %) patients (median age [range], 73.9 [31.6-95.8] years; 59 [82%] men; 69 [96%] White non-Hispanic individuals; 25 [35%] patients with immunosuppression) who were node-negative. The subcohorts were composed of 341 patients with T3N0 cancer, 36 with T4N0, 70 with N1 to 3, and 19 with M1 disease. Pairwise comparisons between disease levels using Cox proportional hazard model demonstrated lower cumulative incidence of CSCC recurrence rates in the T3N0 (HR, 0.21; 95% CI, 0.14-0.30; P < .001) and T4N0 (HR, 0.36; 95% CI, 0.19-0.68; P = .001) cohorts compared with the S-ITM cohort. No significant difference was observed between patients who were node-positive and those with S-ITM (HR, 0.74; 95% CI, 0.48-1.14; P = .16). The 5-year disease-specific survival rates were 76% for T3N0, 64% for T4N0, 41% for S-ITM, and 39% for N1 to 3. Compared with the S-ITM cohort, DSS was significantly higher in the T3N0 (HR, 0.23; 95% CI, 0.15-0.35; P < .0001) and T4N0 (HR, 0.37; 95% CI, 0.19-0.76; P = .01) cohorts, and not significantly different in the node-positive (HR, 0.77; 95% CI, 0.84-3.93; P = .30) and metastatic cohorts (HR, 1.81; 95% CI, 0.84-3.93; P = .13).CONCLUSIONS AND RELEVANCE This multi-institutional cohort study found that patients with CSCC and S-ITM appear to have clinical outcomes comparable to those of patients who are node-positive, and an increased risk of recurrence and worse survival compared with patients who have T3 and T4 disease. These outcomes are similar to those observed for Merkel cell carcinoma and melanoma. Given that S-ITM may be a powerful prognostic factor, it should be ...

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In-Transit Metastasis From Squamous Cell Carcinoma

Cited by 27 publications

References 30 publications

Major prognostic factors for recurrence and survival independent of the American Joint Committee on Cancer eighth edition staging system in patients with cutaneous squamous cell carcinoma treated with multimodality therapy

Major prognostic factors for recurrence and survival independent of the American Joint Committee on Cancer eighth edition staging system in patients with cutaneous squamous cell carcinoma treated with multimodality therapy

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Implications of Satellitosis or In-transit Metastasis in Cutaneous Squamous Cell Carcinoma

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