Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis

Tanamal, Priscilla; Geng, Calvin; Nijhawan, Rajiv I.; Wynings, Erin M.; Balachandra, Sanjana; Myers, Larry L.; Tillman, Brittny N.; Day, Andrew T.

doi:10.1007/s00405-021-06763-z

Cited by 2 publications

(9 citation statements)

References 17 publications

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“…Tanamal et al reported a lower recurrence rate of 2.9% (5 of 173) for cSCC-E following MMS (median follow-up 32 months). 31 This might reflect the exclusive inclusion of primary and earlystage (I-II) SSC-E. They also presented five patients who received WLE and/or parotidectomy and/or neck dissection and/or adjuvant therapy instead of MMS; this group had a recurrence rate of 40% (2 of 5).…”

Section: Specific Site Outcomesmentioning

confidence: 99%

“…reviewed outcomes for cSCC of the ear (cSCC‐E) in 1988, and reported a 5‐year recurrence rate of 7.7% (43 of 558 tumours); however, this included fresh tissue and fixed tissue processing. More recently, there have been three retrospective cohort studies assessing recurrence rate following MMS for SSC‐E 31,34,35 …”

Section: Specific Site Outcomesmentioning

confidence: 99%

“…This might reflect the exclusive inclusion of primary and early‐stage (I–II) SSC‐E. They also presented five patients who received WLE and/or parotidectomy and/or neck dissection and/or adjuvant therapy instead of MMS; this group had a recurrence rate of 40% (2 of 5) 31 . However, the two treatment arms were not randomized or blinded and treatment was decided upon by a multidisciplinary team; therefore, the study was subject to selection bias.…”

Section: Specific Site Outcomesmentioning

confidence: 99%

“…Multiple studies assessed MMS for cSCC with PNI with a varying number of cases and comprehensiveness. 5,12,[17][18][19][20][21][22][28][29][30][31][32] Six studies reported recurrence rates in further detail. 18,19,22,[28][29][30] Leibovitch et al 30 reported a 5-year recurrence rate of 8% (2 of 25; 95% CI 5.2-13.5%), of which 52.9% had received postoperative RT.…”

Section: Recurrence Rates In Special Circumstances: Cutaneous Squamou...mentioning

confidence: 99%

“…Cutaneous squamous cell carcinoma of the ear Mohs et al 33 reviewed outcomes for cSCC of the ear (cSCC-E) in 1988, and reported a 5-year recurrence rate of 7.7% (43 of 558 tumours); however, this included fresh tissue and fixed tissue processing. More recently, there have been three retrospective cohort studies assessing recurrence rate following MMS for SSC-E. 31,34,35 Silapunt et al 34 found that the recurrence rate for SSC-E following MMS was 4.1% (5 of 122) with a mean follow-up of 34.6 months. Unfortunately, owing to a large loss (22%) to follow-up, only 87 tumours had ≥ 2 years of follow-up, and the local recurrence rate in this group increased to 5.7% (5 of 87).…”

Section: Specific Site Outcomesmentioning

confidence: 99%

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A review of Mohs micrographic surgery for skin cancer. Part 3: Squamous cell carcinoma

Hunt

Earp²,

Brown³

et al. 2022

Clinical and Experimental Dermatology

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This review presents and discusses the evidence for MMS to treat cutaneous squamous cell carcinoma (cSCC). The MEDLINE, Embase and Cochrane databases were searched; 39 papers were identified for recurrence and 2 papers for costeffectiveness. We included all clinical trials and observational studies, including retrospective reports, and excluded editorials and systematic reviews or meta-analyses. We categorized the evidence under the following headings: tumour recurrence, specific site outcomes (ear, lip, scalp and periocular), cSCC with perineural invasion, and cost-effectiveness. Although there are many observational studies indicating the potential benefits of MMS in the management of certain cSCCs, no randomized controlled trials (RCT) were identified. The evidence from comparitor studies suggests that MMS has a lower recurrence rate than that of other treatments for cSCC, including standard excision. Many studies identified were single-armed, but did demonstrate a low to very low recurrence rate of cSCC following MMS. A single recent study suggests MMS for intermediate cSCC is highly cost-effective compared with wide local excision when all-in costs are considered. Since the overall quality of included studies was mixed and highly heterogeneous, further methodologically robust studies with comparator arms or comprehensive long-term registry data would be valuable. It would be ideal to employ a definitive multicentre RCT but given the evidence to date and multiple advantages to MMS, the lack of clinical equipoise makes this difficult to justify. Comparison with current modalities would likely not be ethical/achievable on a like-for-like basis given MMS provides 100% margin assessment, enables histological clearance prior to reconstruction, and minimizes the removal of uninvolved tissue.

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Section: Specific Site Outcomesmentioning

confidence: 99%

Section: Specific Site Outcomesmentioning

confidence: 99%

Section: Specific Site Outcomesmentioning

confidence: 99%

Section: Recurrence Rates In Special Circumstances: Cutaneous Squamou...mentioning

confidence: 99%

Section: Specific Site Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

A review of Mohs micrographic surgery for skin cancer. Part 3: Squamous cell carcinoma

Hunt

Earp²,

Brown³

et al. 2022

Clinical and Experimental Dermatology

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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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Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis

Cited by 2 publications

References 17 publications

A review of Mohs micrographic surgery for skin cancer. Part 3: Squamous cell carcinoma

A review of Mohs micrographic surgery for skin cancer. Part 3: Squamous cell carcinoma

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

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