Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient

McLaughlin, Eamon J.; Miller, Lindsay M.; Shin, Thuzar M.; Sobanko, Joseph F.; Cannady, Steven B.; Miller, Christopher J.; Newman, Jason G.

doi:10.1016/j.amjoto.2017.01.035

Cited by 24 publications

(32 citation statements)

References 27 publications

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“…The included studies were published between 1980 and 2017; the Metastasis squamous cell carcinoma Table 2 Details of studies regarding special locations or high-risk tumours Metastasis squamous cell carcinoma number of included patients ranged from 34 to 796 (Table 1). [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] These studies were performed in the USA, New Zealand, Australia, The Netherlands, France, Portugal and Israel. Follow-up in these studies was mainly calculated from time of transplantation instead of follow-up from cSCC development.…”

Section: Studies In Otrmentioning

confidence: 99%

“…Thirteen studies included patients with cSCC on the total body, [42][43][44][45][46][47][48][49][51][52][53]56,57 three studies reported on patients with a cSCC in the head and neck area. 50,54,55 Studies in the immunocompetent population…”

Section: Studies In Otrmentioning

confidence: 99%

“…24,30,52,54,83,85 Seven studies reported on loss of follow-up 30,45,50,57,81,82,86 with a loss of follow-up of more than 5% in 6/7. 30,45,50,57,81,86 One study excluded patients with follow-up less than 6 months, 50 and one study included only patients with a minimum followup of more than 1 year. 86 One study stated that a protocol was followed annually to detect metastasis with radiological imaging.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…42,44,50,55 In seven studies, the distribution of T-stage among the cSCC was mentioned. 50,55,78,81,86,87,89 In 21 studies, one or more tumour related potential high-risk features factors for metastasis, such as size, location, depth of invasion or perineural invasion, were taken into account. One study in the immunocompetent population specifically stated that no OTR were included in the cohort of the immunocompetent population.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…44,47 In 14 studies, the outcome of metastasis was specifically noted in the study aim. 22,25,44,48,50,[78][79][80][81][82]84,[87][88][89] Metastasis risk: pooled analysis Summary estimates were calculated for the proportion of patients with metastasis in the studies reporting on total body (Fig. 2) and cSCC of the head and neck area (Fig.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Genders

Weijns

Dekkers

et al. 2019

Acad Dermatol Venereol

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Background Organ transplant recipients (OTR) have a higher risk of developing cutaneous squamous cell carcinoma (cSCC) compared to the immunocompetent population. Immunosuppression is often stated as a risk factor for metastasis. However, evidence for this is scarce.Objectives To investigate the cSCC metastasis risk in OTR and the immunocompetent population by systematically reviewing the literature.Methods A systematic review of the literature was performed up to January 2018 using: Medline; Embase; Web of Science and ISI Science Citation Index. Studies assessing cSCC metastasis risk in ORT or immunocompetent cohorts were considered. A pooled risk estimate for metastasis was calculated for the immunocompetent population and OTR separately. ResultsThe pooled metastasis risk estimate for OTR was, respectively, 7.3% (95% CI 6.2-8.4) for cSCC on total body, and 11.0% (95% CI 7.7-14.8) for cSCC of the head neck area. For the immunocompetent population reported risk estimate analysis showed a pooled metastatic risk of 3.1% (95% CI 2.8-3.4) in total body cSCC and of 8.5% (95% CI 7.3-9.8) in cSCC of the head and neck area.Pooled risk estimate per single cSCC in OTR was 1.3% (95% CI 1.0-1.7) in total body cSCC and 4.0% (95% CI 2.7-5.5) in cSCC of the head and neck area. In the immunocompetent population, these pooled risk estimates were, respectively, 2.4% (95% CI 2.1-2.6) and 6.7% (95% CI 5.7-7.8).Conclusions Organ transplant recipients show a higher overall risk of cSCC metastasis compared to the immunocompetent population. Metastasis risks per single cSCC were substantially lower in both groups. However, due to heterogeneity and differences between studies, comparisons are difficult. Comprehensive follow-up studies with defined cohorts are necessary to adequately asses the risk for cSCC metastasis.

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Section: Studies In Otrmentioning

confidence: 99%

Section: Studies In Otrmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Genders

Weijns

Dekkers

et al. 2019

Acad Dermatol Venereol

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Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

et al. 2023

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ImportancePrimary cutaneous squamous cell carcinoma is usually curable; however, a subset of patients develops poor outcomes, including local recurrence, nodal metastasis, distant metastasis, and disease-specific death.ObjectivesTo evaluate all evidence-based reports of patient risk factors and tumor characteristics associated with poor outcomes in primary cutaneous squamous cell carcinoma and to identify treatment modalities that minimize poor outcomes.Data SourcesPubMed, Embase, and SCOPUS databases were searched for studies of the topic in humans, published in the English language, from database inception through February 8, 2022.Study SelectionTwo authors independently screened the identified articles and included those that were original research with a sample size of 10 patients or more and that assessed risk factors and/or treatment modalities associated with poor outcomes among patients with primary cutaneous squamous cell carcinoma.Data Extraction and SynthesisData extraction was performed by a single author, per international guidelines. The search terms, study objectives, and protocol methods were defined before study initiation. A total of 310 studies were included for full-text assessment. Owing to heterogeneity of the included studies, a random-effects model was used. Data analyses were performed from May 25 to September 15, 2022.Main Outcomes and MeasuresFor studies of risk factors, risk ratios and incidence proportions; and for treatment studies, incidence proportions.ResultsIn all, 129 studies and a total of 137 449 patients with primary cutaneous squamous cell carcinoma and 126 553 tumors were included in the meta-analysis. Several patient risk factors and tumor characteristics were associated with local recurrence, nodal metastasis, distant metastasis, disease-specific death, and all-cause death were identified. Among all factors reported by more than 1 study, the highest risks for local recurrence and disease-specific death were associated with tumor invasion beyond subcutaneous fat (risk ratio, 9.1 [95% CI, 2.8-29.2] and 10.4 [95% CI, 3.0- 36.3], respectively), and the highest risk of any metastasis was associated with perineural invasion (risk ratio, 5.0; 95% CI, 2.3-11.1). Patients who received Mohs micrographic surgery had the lowest incidence of nearly all poor outcomes; however, in some results, the 95% CIs overlapped with those of other treatment modalities.Conclusions and RelevanceThis meta-analysis identified the prognostic value of several risk factors and the effectiveness of the available treatment modalities. These findings carry important implications for the prognostication, workup, treatment, and follow-up of patients with primary cutaneous squamous cell carcinoma.Trial RegistrationPROSPERO Identifier: CRD42022311250

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Elective neck dissection versus observation in patients with head and neck cutaneous squamous cell carcinoma

Amit

Liu

Mansour

et al. 2021

Cancer

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BACKGROUND:The survival benefit of elective neck dissection (END) for patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck and no evidence of regional metastasis (cN0) has never been reported. The aim of this study was to determine the effect of END on patient survival. METHODS: The authors included patients with head and neck cSCC who had undergone primary surgery from 1995 to 2017. The primary end point was survival, and the secondary end points were the incidence of occult regional disease and regional disease control. To assess the impact of END on survival, the authors used multivariable Cox proportional hazards models with propensity score and matching techniques for internal validation. RESULTS: A total of 1111 patients presented with no evidence of nodal disease; 173 had END, and 938 were observed. Adjuvant radiotherapy to the neck was administered to 101 patients (9%). END resulted in a 5-year overall survival rate of 52%, whereas the rate was 63% in the observation group (P = .003 [log-rank]). The 5-year disease-free survival rate for patients undergoing END was similar to that for the observation group (73% vs 75%; P = .429). A multivariate regression model showed that the performance of END was not associated with improved rates of overall, disease-specific, or disease-free survival; similarly, among patients with advanced disease (T3-4), those who underwent END did not have improved survival rates. CONCLUSIONS: Among patients with cSCC of the head and neck, observation of the neck nodes resulted in noninferior survival rates in comparison with END at the time of primary surgery. Further studies are required to elucidate the role of END in patients with advanced disease. Cancer 2021;127:4413-4420.

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Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient

Cited by 24 publications

References 27 publications

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

Elective neck dissection versus observation in patients with head and neck cutaneous squamous cell carcinoma

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