Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up

Rose, Aidan M.; Nicoll, K.; Moinie, Ahmad; Jordan, Daniel J; Evans, Alan; Proby, Charlotte M.; Naasan, Anas

doi:10.1016/j.bjps.2017.03.006

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…15,16,18,[20][21][22][23][24][25] Low-risk cSCC (<2 cm, depth not beyond dermis, good differentiation grade) metastasize only in 0-3%. [26][27][28][29] Presence of risk factors, like large tumour size (>2 cm), deep infiltration, location on the lip or ear, poor differentiation grade and perineural and lymphovascular invasion increase the risk for metastasis up to 40%. 2,16,23,30,31 Currently, tumour depth is identified as the most important risk factor for metastasis.…”

Section: Introductionmentioning

confidence: 99%

“…Metastases occur in approximately 5% (range 0.1–9.9%) of cSCC, usually to regional lymph nodes . Low‐risk cSCC (<2 cm, depth not beyond dermis, good differentiation grade) metastasize only in 0–3% . Presence of risk factors, like large tumour size (>2 cm), deep infiltration, location on the lip or ear, poor differentiation grade and perineural and lymphovascular invasion increase the risk for metastasis up to 40% .…”

Section: Introductionmentioning

confidence: 99%

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Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Genders

Weijns

Dekkers

et al. 2019

Acad Dermatol Venereol

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Background Organ transplant recipients (OTR) have a higher risk of developing cutaneous squamous cell carcinoma (cSCC) compared to the immunocompetent population. Immunosuppression is often stated as a risk factor for metastasis. However, evidence for this is scarce.Objectives To investigate the cSCC metastasis risk in OTR and the immunocompetent population by systematically reviewing the literature.Methods A systematic review of the literature was performed up to January 2018 using: Medline; Embase; Web of Science and ISI Science Citation Index. Studies assessing cSCC metastasis risk in ORT or immunocompetent cohorts were considered. A pooled risk estimate for metastasis was calculated for the immunocompetent population and OTR separately. ResultsThe pooled metastasis risk estimate for OTR was, respectively, 7.3% (95% CI 6.2-8.4) for cSCC on total body, and 11.0% (95% CI 7.7-14.8) for cSCC of the head neck area. For the immunocompetent population reported risk estimate analysis showed a pooled metastatic risk of 3.1% (95% CI 2.8-3.4) in total body cSCC and of 8.5% (95% CI 7.3-9.8) in cSCC of the head and neck area.Pooled risk estimate per single cSCC in OTR was 1.3% (95% CI 1.0-1.7) in total body cSCC and 4.0% (95% CI 2.7-5.5) in cSCC of the head and neck area. In the immunocompetent population, these pooled risk estimates were, respectively, 2.4% (95% CI 2.1-2.6) and 6.7% (95% CI 5.7-7.8).Conclusions Organ transplant recipients show a higher overall risk of cSCC metastasis compared to the immunocompetent population. Metastasis risks per single cSCC were substantially lower in both groups. However, due to heterogeneity and differences between studies, comparisons are difficult. Comprehensive follow-up studies with defined cohorts are necessary to adequately asses the risk for cSCC metastasis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Genders

Weijns

Dekkers

et al. 2019

Acad Dermatol Venereol

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“…Factors associated with risk of poor disease-related outcomes (local recurrence, nodal metastasis, disease-specific death) in multiple studies using univariate or multivariate analysis. [13][14][15][16][17][18] cSCC, cutaneous squamous cell carcinoma; GP, general practitioner; HAART, highly active antiretroviral therapy; LSMDT, local skin cancer multidisciplinary team; SCID, severe combined immunodeficiency; SSMDT, specialist skin cancer multidisciplinary team. *Review of nodal basins in the head and neck should be per the criteria of the head and neck MDT.…”

Section: Review Question 5: Adjuvant Radiotherapymentioning

confidence: 99%

“…For definition of the levels of risk see Figure 1. [13][14][15][16][17][18] R7 (↑↑) Ensure at least a 1-mm histological clearance of cSCC excisions at all margins by including sufficient peripheral and deep tissues (see R6 for appropriate standard surgical excision margins).…”

Section: R6 (↑↑)mentioning

confidence: 99%

“…This referral guidance relates to primary cSCC, where treatment has been excisional surgery with curative intent. Factors associated with risk of poor disease‐related outcomes (local recurrence, nodal metastasis, disease‐specific death) in multiple studies using univariate or multivariate analysis 13–18 . cSCC, cutaneous squamous cell carcinoma; GP, general practitioner; HAART, highly active antiretroviral therapy; LSMDT, local skin cancer multidisciplinary team; SCID, severe combined immunodeficiency; SSMDT, specialist skin cancer multidisciplinary team.…”

Section: Summary Of Recommendationsmentioning

confidence: 99%

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British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020*

Keohane¹,

et al. 2021

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Reply to: ‘Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up’

Jakharia-Shah

Chadha

Geh

2017

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up

Cited by 5 publications

References 3 publications

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020*

Reply to: ‘Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up’

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