Cutaneous squamous cell carcinoma of head and neck region: A single center analysis of 1296 tumors with clinical characteristics, comorbidities, treatment, and sun‐protection behavior

Abstract

Cutaneous squamous cell carcinoma (SCC) is the second most common nonmelanoma skin cancer among Caucasians. We analyzed our data on tumors been treated between 2006 and 2016 at the Skin Cancer Center of an academic teaching hospital. Thousand hundred and ninety-four patients with 1296 SCC have been identified including 804 males (67.3%) and 390 females (32.7%). The mean age among females was significantly higher with (83.9 ± 7.9) years compared with males ([79.3 ± 8.1] years; P < .001). The most common tumor localizations were outer ears (n = 227, 17.5%), scalp (216, 16.7%), and forehead (215, 16.6%). The majority of tumors was stage I. 31.9% of patients had previous SCC or Bowen's cancer, 29.1% had actinic keratoses. Major non-dermatological comorbidities were cardiovascular diseases and diabetes. SCC were treated by delayed Mohs surgery. First Mohs procedure resulted in R0 status in 83.9%. Most cases with R1 resection were located on nose and eyelids. For a subpopulation of patients (n = 105), a structured questionnaire study evaluated changes in sun protection behavior after skin cancer. After the confirmed diagnosis of a cutaneous SCC concerns about harm to the skin by intense sunlight was reported by 78.4% (76) of participants, with 92.0% among females versus 73.6% among males. Eighty percent of females and 76.8% of males wanted to care more about sun-protection in the future, spend less time 84.0% (females) and 72.5% (males) in the sun, and adapt their leisure activities for a better sun protection in 92.0% (females) and 81.9% (males). Secondary prevention in males needs improvement.

Impact of AJCC 8 pT staging in cutaneous head and neck squamous cell carcinoma in a nonselected real‐world patient sample

“…Some current pT2 tumors may be associated with poor outcomes (0 related deaths but 2 [11.1%] recurrences in this group in our sample), and very few tumors meet the criteria for T4 subgroup (5 cases in our sample), which is used rarely. In a large dermatology single center series of 1296 HNCSCC cases from Germany, no pT4 were present 23 …”

“…In a large dermatology single center series of 1296 HNCSCC cases from Germany, no pT4 were present. 23 Contrary to Karia et al, 6 we opted to exclude lip cancers, as controversies between chapters on oral cancer and HNCSCC preclude a clear classification of malignant neoplasms of the lips, and we do not have a comparative study that determines which staging model is the most appropriate for each anatomical region of this topography (skin, vermilion border, or mucosa).…”