In-Transit Metastasis From Primary Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients and Nonimmunosuppressed Patients: Clinical Characteristics, Management, and Outcome in a Series of 21 Patients

Carucci, John A.; Martı́nez, Juan Carlos; Zeitouni, Nathalie C.; Christenson, Leslie J.; Coldiron, Brett M.; Zweibel, Stuart; Otley, Clark C.

doi:10.1111/j.1524-4725.2004.30151.x

Cited by 80 publications

(128 citation statements)

References 17 publications

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“…Many of the immunosuppressive agents used in OTRs to prevent organ rejection have direct or indirect suppression of T-cell function. 7 Carucci et al 8 suggested that in-transit metastases tend to occur after high-risk SCC more frequently in OTRs than in patients who have not received transplants. They also noted that these in-transit metastases tended to occur after high-risk tumors of the forehead or scalp and were associated with a poor prognosis in OTRs.…”

Section: T H E R E a R E M O R E T H A Nmentioning

confidence: 99%

Special Concern About Squamous Cell Carcinoma of the Scalp in Organ Transplant Recipients

Cooper¹,

Brown²

2006

Arch Dermatol

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Section: T H E R E a R E M O R E T H A Nmentioning

confidence: 99%

Special Concern About Squamous Cell Carcinoma of the Scalp in Organ Transplant Recipients

Cooper¹,

Brown²

2006

Arch Dermatol

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“…50 Most (15 of 22) of the primary tumors were located on the head and face; although, in 3 of 22 subjects, the primary tumor site could not be determined. 50 In-transit metastases were discovered an average of 10 weeks after treatment of the primary tumor. 50 Intransit metastases were more common in OTR and associated with increased morbidity and mortality.…”

Section: In-transit Metastasismentioning

confidence: 90%

“…50 In that study, the in-transit metastases tended to be less than 8.0 mm in size with mean distance of 2.5 cm from the primary tumor. 50 Most (15 of 22) of the primary tumors were located on the head and face; although, in 3 of 22 subjects, the primary tumor site could not be determined. 50 In-transit metastases were discovered an average of 10 weeks after treatment of the primary tumor.…”

Section: In-transit Metastasismentioning

confidence: 95%

“…50 In-transit metastases were discovered an average of 10 weeks after treatment of the primary tumor. 50 Intransit metastases were more common in OTR and associated with increased morbidity and mortality. Most of the tumors were managed with either MMS or standard excision, with subsequent radiation, although in a few, radiotherapy was used alone.…”

Section: In-transit Metastasismentioning

confidence: 99%

“…9). 50 They appear as pinkish gray, nondescript papules, 2 to 8 mm in diameter. 20 It should be noted that the definition of in-transit metastasis differs in melanoma, where in-transit metastases are defined by the American Joint Committee on Cancer staging criteria as occurring more than 2 cm from primary tumor; whereas, those within 2 cm are termed satellites; however, satellites are thought to carry similar prognosis.…”

Section: In-transit Metastasismentioning

confidence: 99%

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Mohs Surgery for Squamous Cell Carcinoma

Belkin

Carucci

2011

Dermatologic Clinics

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Implications of Satellitosis or In-transit Metastasis in Cutaneous Squamous Cell Carcinoma

et al. 2022

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cell carcinoma and melanoma, satellitosis or in-transit metastasis (S-ITM) is not incorporated into the current cutaneous squamous cell carcinoma (CSCC) staging systems. It is important to determine if the clinical outcomes of S-ITM are relevant to prognosis for patients with CSCC.OBJECTIVES To evaluate the association of S-ITM with clinical outcomes in patients with CSCC and to determine its prognostic implications. DESIGN, SETTINGS, AND PARTICIPANTSA dual-institution (Cleveland Clinic and Brigham and Women's Hospital) database was queried for patients who were treated for CSCC in 2010 to 2020. Patients who were node-negative and had S-ITM-the presence of dermal lesions between the primary tumor and first-echelon lymphatic nodal basins at any point in the disease course-were identified. Subcohorts of patients with T3N0 tumors, T4N0 tumors (bone invasive), N1 to 3, and M1 disease were identified for comparison. The American Joint Committee on Cancer staging system was used to define cancer stages. Data were analyzed from January 15 to March 31, 2021. MAIN OUTCOMES AND MEASURESPairwise comparison of CSCC recurrence and disease-specific survival in patients with and without S-ITM was performed using Cox proportional hazard modeling. Kaplan-Meier and Fine-Gray competing risk methods were used to estimate disease-specific survival and CSCC recurrence, respectively. RESULTSIn a total of 518 patients with CSCC, S-ITM was present in 72 (13.9 %) patients (median age [range], 73.9 [31.6-95.8] years; 59 [82%] men; 69 [96%] White non-Hispanic individuals; 25 [35%] patients with immunosuppression) who were node-negative. The subcohorts were composed of 341 patients with T3N0 cancer, 36 with T4N0, 70 with N1 to 3, and 19 with M1 disease. Pairwise comparisons between disease levels using Cox proportional hazard model demonstrated lower cumulative incidence of CSCC recurrence rates in the T3N0 (HR, 0.21; 95% CI, 0.14-0.30; P < .001) and T4N0 (HR, 0.36; 95% CI, 0.19-0.68; P = .001) cohorts compared with the S-ITM cohort. No significant difference was observed between patients who were node-positive and those with S-ITM (HR, 0.74; 95% CI, 0.48-1.14; P = .16). The 5-year disease-specific survival rates were 76% for T3N0, 64% for T4N0, 41% for S-ITM, and 39% for N1 to 3. Compared with the S-ITM cohort, DSS was significantly higher in the T3N0 (HR, 0.23; 95% CI, 0.15-0.35; P < .0001) and T4N0 (HR, 0.37; 95% CI, 0.19-0.76; P = .01) cohorts, and not significantly different in the node-positive (HR, 0.77; 95% CI, 0.84-3.93; P = .30) and metastatic cohorts (HR, 1.81; 95% CI, 0.84-3.93; P = .13).CONCLUSIONS AND RELEVANCE This multi-institutional cohort study found that patients with CSCC and S-ITM appear to have clinical outcomes comparable to those of patients who are node-positive, and an increased risk of recurrence and worse survival compared with patients who have T3 and T4 disease. These outcomes are similar to those observed for Merkel cell carcinoma and melanoma. Given that S-ITM may be a powerful prognostic factor, it should be ...

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In-Transit Metastasis From Primary Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients and Nonimmunosuppressed Patients: Clinical Characteristics, Management, and Outcome in a Series of 21 Patients

Cited by 80 publications

References 17 publications

Special Concern About Squamous Cell Carcinoma of the Scalp in Organ Transplant Recipients

Special Concern About Squamous Cell Carcinoma of the Scalp in Organ Transplant Recipients

Mohs Surgery for Squamous Cell Carcinoma

Implications of Satellitosis or In-transit Metastasis in Cutaneous Squamous Cell Carcinoma

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