Identifying Brigham and Women's Hospital stage T2a cutaneous squamous cell carcinomas at risk of poor outcomes

Gupta, Neha; Weitzman, Rachel; Murad, Fadi; Koyfman, Shlomo A.; Smile, Timothy D.; Chang, Michael S.; Maher, Jacqueline; Schmults, Chrysalyne D.; Vidimos, Allison; Ruiz, Emily S.

doi:10.1016/j.jaad.2021.11.046

Cited by 9 publications

(15 citation statements)

References 13 publications

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“…The recommended components of the synoptic report include the following (Figure 1):Tumor stage: The authors recommend using both the AJCC-8 (for tumors on the head and neck) and the BWH staging systems, as AJCC-8 is most commonly used in multidisciplinary settings and BWH adds valuable prognostic information. 2,3 Tumor diameter: This is recorded as the largest clinical diameter or the length and width of the lesion before treatment.Differentiation: Keratinization, cellular atypia, and architecture are considered when grading differentiation. 4 Tumors may be categorized as well, moderately, or poorly differentiated or undifferentiated.…”

Section: Synoptic Reportingmentioning

confidence: 99%

“…Tumor stage: The authors recommend using both the AJCC-8 (for tumors on the head and neck) and the BWH staging systems, as AJCC-8 is most commonly used in multidisciplinary settings and BWH adds valuable prognostic information. 2,3…”

Section: Synoptic Reportingmentioning

confidence: 99%

“…2 The BWH system performs better overall; however, 26% of nodal metastases and 8% of disease-specific deaths occur within the T2a group. 3 Recent work has focused on the relative impact of individual HRFs 3 and further subcategorization of the current staging systems to more accurately stratify risk. 2,3 Tumor staging should be standard practice for CSCC, as it is with other malignancies.…”

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confidence: 99%

“…3 Recent work has focused on the relative impact of individual HRFs 3 and further subcategorization of the current staging systems to more accurately stratify risk. 2,3…”

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confidence: 99%

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How We Do It: Synoptic Reporting for Cutaneous Squamous Cell Carcinoma During Mohs Micrographic Surgery

O’Connor

Shahwan

Carr

2022

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Section: Synoptic Reportingmentioning

confidence: 99%

Section: Synoptic Reportingmentioning

confidence: 99%

mentioning

confidence: 99%

“…3 Recent work has focused on the relative impact of individual HRFs 3 and further subcategorization of the current staging systems to more accurately stratify risk. 2,3…”

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confidence: 99%

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How We Do It: Synoptic Reporting for Cutaneous Squamous Cell Carcinoma During Mohs Micrographic Surgery

O’Connor

Shahwan

Carr

2022

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“…2 Because of reported health disparities for LEP patients, for this study, we used the National Health and Nutrition Examination Surveys (NHANES), a national database which collects patients' language and age of diagnosis. 3 This study was deemed exempt from review and approval by the institutional review board. A retrospective crosssectional study was performed with pooled data from the 1999/2000 through 2017/2018 NHANES.…”

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confidence: 99%

The Use of Freezer Paper for Thin, Fragile Specimens in Mohs Surgery

McGuinness

Richey

Fair

et al. 2022

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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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Identifying Brigham and Women's Hospital stage T2a cutaneous squamous cell carcinomas at risk of poor outcomes

Cited by 9 publications

References 13 publications

How We Do It: Synoptic Reporting for Cutaneous Squamous Cell Carcinoma During Mohs Micrographic Surgery

How We Do It: Synoptic Reporting for Cutaneous Squamous Cell Carcinoma During Mohs Micrographic Surgery

The Use of Freezer Paper for Thin, Fragile Specimens in Mohs Surgery

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

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