Prognostic factors for satellitosis or in-transit metastasis in cutaneous squamous cell carcinoma: A multicentric cohort study

Marti‐Marti, Ignasi; Podlipnik, Sebastián; Cañueto, Javier; Ferrándiz-Pulido, Carla; Deza, Gustavo; Sanmartín, O.; Jaka, Ane; Beà-Ardèbol, Sonia; Botella‐Estrada, Rafael; Redondo, Pedro; Turrión-Merino, Lucía; Ruiz‐Salas, Verónica; Masferrer, Emili; Yébenes, Mireia; Sánchez-Schmidt, Júlia-María; Gracia‐Darder, Inés; Altemir, Arcadi; Aguayo-Ortiz, Rafael S; Becerril, Sara; Bodet-Castillo, Domingo; Leal, Lorena; Fuente, María José De La; Moreno‐Arrones, Óscar M.; Abril‐Pérez, Carlos; Tomás‐Velázquez, Alejandra; Sandoval-Clavijo, Alejandra; Toll, Alba

doi:10.1016/j.jaad.2023.02.048

Cited by 3 publications

(7 citation statements)

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“…Satellitosis or in-transit metastases (S-ITM) are nonepidermal lesions originating between the primary tumor and the first tumor-draining lymph nodes, considering as satellitosis those that occur within 2 cm of the primary tumor. They are thought to occur as a consequence of intralymphatic or possibly angiotropic tumor spread [83], and are more common in immunosuppressed patients [83,84]. S-ITM have proved to be an independent poor-outcome risk factor in cSCCs [83,[85][86][87], with outcomes comparable to node-positivity in terms of recurrence and disease-specific survival [86].…”

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

“…They are thought to occur as a consequence of intralymphatic or possibly angiotropic tumor spread [83], and are more common in immunosuppressed patients [83,84]. S-ITM have proved to be an independent poor-outcome risk factor in cSCCs [83,[85][86][87], with outcomes comparable to node-positivity in terms of recurrence and disease-specific survival [86]. A recent study of Marti-Marti et al, demonstrated that the size (≥20 mm) and the number of lesions (>5) of S-ITM are two independent prognostic factors for relapse, and the number of lesions for specific death [83].…”

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

“…The head and neck region is the most common location of S-ITM [83,84], occurring more commonly in the scalp (Figure 6) [84]. poor-outcome risk factor in cSCCs [83,[85][86][87], with outcomes comparable to node-positivity in terms of recurrence and disease-specific survival [86].…”

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

“…The head and neck region is the most common location of S-ITM [83,84], occurring more commonly in the scalp (Figure 6) [84]. Although uncommon, S-ITM represent an authentic management challenge as they are not included in current cSCC staging systems and guidelines [7,39,51].…”

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

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Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Verdaguer-Faja,

Toll,

Boada

et al. 2024

Cancers

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Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic thickness and anatomical structure that may influence both growth pattern and treatment of primary cSCC; while clinical peripheral margins may be easily achieved during the surgery, vertical excision of the tumor is limited by the skull. Despite having a unique anatomy, current guidelines do not contemplate specific recommendations for scalp cSCC, which leads to inconsistent decision-making in multidisciplinary committees when discussing tumors with high risk factors or with close margins. This article provides specific recommendations for the management of patients with scalp cSCC, based on current evidence, as well as those aspects in which evidence is lacking, pointing out possible future lines of research. Topics addressed include epidemiology, clinical presentation and diagnosis, imaging techniques, surgical and radiation treatments, systemic therapy for advanced cases, and follow-up. The primary focus of this review is on management of primary cSCC of the scalp with localized disease, although where relevant, some points about recurrent cSCCs or advanced disease cases are also discussed.

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Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

Section: Management Of Locoregional Disease 41 Management Of Patients...mentioning

confidence: 99%

See 2 more Smart Citations

Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Verdaguer-Faja,

Toll,

Boada

et al. 2024

Cancers

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“…Prior research on cutaneous metastasis is limited; however, they typically confer poor prognosis and are a manifestation of end-stage disease (3). A multicentric cohort study in March 2023 found that the size and number of in-transit metastases are associated with an increased risk of relapse, and the number of intransit metastases is associated with decreased survival (4).…”

Section: Introductionmentioning

confidence: 99%

Case report: Regression of in-transit metastases of cutaneous squamous cell carcinoma with combination pembrolizumab and topical diphencyprone

Poplausky,

Young,

Block

et al. 2024

Front. Oncol.

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While typically low-risk, cutaneous squamous cell carcinoma (cSCC) can infrequently progress to metastatic disease with in-transit lesions, localized to the dermis or subcutaneous tissue between the primary tumor and draining regional lymph nodes. These lesions are associated with poor prognostic values, including decreased survival rates and increased risk of recurrence. We present the case of a 75-year-old male with cSCC and in-transit metastases on his scalp treated with the immune checkpoint inhibitor (ICI) pembrolizumab in conjunction with diphencyprone (DPCP), a topical hapten that induces a delayed-type hypersensitivity reaction in the skin. The patient was enrolled in a clinical trial (NCT05481658) that involved the twice-weekly application of DPCP 0.04% ointment to four of the in-transit metastases on his frontal scalp, concurrent with pembrolizumab 300 mg administered every three weeks. Following effective sensitization and a twelve-week treatment course, complete clearance of all lesions, DPCP-treated and non-DPCP treated, was achieved, with no adverse events. The immunologic profiles of the post-treatment biopsies were analyzed by TaqMan Low Density Array quantitative real-time polymerase chain reaction to measure immune marker gene expression. Relative to the non-DPCP-treated lesion, the DPCP-treated lesion demonstrated increased pro-inflammatory genetic markers and T-cell activation. This case represents the first reported instance of in-transit metastases of cSCC successfully treated with DPCP and an ICI. It highlights the potential safety and efficacy of DPCP with systemic immunotherapy for the management of in-transit metastases of cSCC in patients for whom surgery and radiation may be contraindicated.

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Tumour budding as a risk factor for lymph node metastases in cutaneous squamous cell carcinoma: a systematic review and meta-analysis

Gil-Pallares,

Navarro-Bielsa

et al. 2024

Clinical and Experimental Dermatology

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Background Current staging systems have limitations in stratifying high-risk cases of cutaneous squamous cell carcinoma (cSCC). Tumor budding (TB) has emerged as a potential prognostic factor in various cancers. Objectives This systematic review and meta-analysis aimed to evaluate the prognostic significance of TB in predicting lymph node metastases (NM) in cSCC. Methods A comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane databases was conducted. Studies investigating the association of TB using a 5-bud cut-off and NM in cSCC were included. A meta-analysis was performed using odds ratios (OR) to evaluate the association between TB and NM. Results Six retrospective studies comprising 793 cSCC patients were included. The random-effects analysis showed a significant association between high TB (≥5 buds) and NM (OR = 13.29, 95% CI = 5.55; 31.86). Discussion Tumor budding is a promising histopathologic feature for predicting NM in cSCC. The results show a strong association between high TB and NM, supporting its utility as a risk factor for NM in cSCC. Its inclusion in clinical practice and cSCC staging might be helpful in the stratification of high-risk cases and guide optimal management strategies for each patient. However, further investigation is needed to determine standardized reporting guidelines for TB in cSCC.

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Prognostic factors for satellitosis or in-transit metastasis in cutaneous squamous cell carcinoma: A multicentric cohort study

Cited by 3 publications

References 10 publications

Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Case report: Regression of in-transit metastases of cutaneous squamous cell carcinoma with combination pembrolizumab and topical diphencyprone

Tumour budding as a risk factor for lymph node metastases in cutaneous squamous cell carcinoma: a systematic review and meta-analysis

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