Cutaneous Squamous Cell Carcinoma: Defining the High-Risk Variant

Abstract

With a lifetime incidence of approximately 10% in the general population, cutaneous squamous cell carcinoma (CSCC) is the second most common type of nonmelanoma skin cancer. Most CSCCs are benign and can be completely eradicated by surgery or other dermatological procedures. There is, however, a subgroup associated with an increased likelihood of lymph node metastases and, therefore, with high morbidity and mortality. This article analyzes the various factors that define aggressive CSCC. We propose a method for defining high-risk SCC on the basis of a series of major and minor criteria. This method will allow better prognostic evaluation and enable personalized management of patients with high-risk SCC, possibly leading to improved overall survival.

High-risk cutaneous squamous cell carcinoma and the emerging role of sentinel lymph node biopsy: A literature review

“…All patients with positive SLN had cSCC larger than 2 cm in diameter. Using the alternative TNM system no cases (0 of 9 patients) of a positive SLN were documented in T1 primary (0 risk factors), 7.1% in Data collected and modified from Rowe et al, 25 Alam and Ratner, 2 Nuño-Gonz alez et al, 15 Brantsch et al, 9 Martorell-Calatayud et al, 17 Veness et al, 16,32 Ross and Schmults, 31 Tomaszewski et al, 23 and Brougham and Tan. 7 CLL, Chronic lymphocytic leukemia; cSCC, cutaneous squamous cell carcinoma; RR, relative risk or hazard risk.…”

“…[15][16][17] Numerous studies have documented high-risk factors associated with poor outcomes (Table I). [8][9][10]13,15,[17][18][19] Based on a combination of consensus and low level evidence, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th Edition (AJCC-7), identified 5 high-risk features. 20 Patients with 2 or more high-risk features were categorized as a T2 primary irrespective of size.…”

Role of Sphingolipids in Non-melanoma Skin Cancer

“…If left untreated, however, BCC may cause destruction of underlying tissues [ 12 ]. SCC is the second most frequent NMSC, with approximately 700,000 in the United States and 2-3 million new cases worldwide being diagnosed [ 10 , 13 , 14 ], and its incidence is markedly increased in immunocompromised patients [ 15 ]. Although most SCC cases can be cured by surgical removal, about 8 % of the cases relapse and 5 % metastasize.…”

Sentinel lymph node biopsy for cutaneous squamous cell carcinoma: valuable or not valuable?

“…The risk of metastasis is around 3–6%, but may increase to 20% in high‐risk SCC . The challenge in daily practice is to identify high‐risk SCC and to detect a metastasis as early as possible …”