Squamous cell carcinoma of the skin: epidemiology, classification, management, and novel trends

Kallini, Joseph R.; Hamed, Nouran; Khachemoune, Amor

doi:10.1111/ijd.12553

Cited by 208 publications

(169 citation statements)

References 73 publications

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“…If metastases occur, prognosis decreases drastically [5] . Prognostic parameters, being associated with an elevated metastatic risk, are immunosuppression, moderate/poor histological differentiation, perineural and lymphovascular invasion, local recurrence, median tumour diameter >2 cm, tumour thickness >2 mm and location on the ear [10,12] . The identification of further reliable parameters, indicating the metastatic risk, is important for the implementation of additional diagnostic and therapeutic procedures such as sentinel lymph node biopsies or intensified follow-up care including imaging procedures.…”

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confidence: 99%

Characterisation of Prognosis and Invasion of Cutaneous Squamous Cell Carcinoma by Podoplanin and E-Cadherin Expression

et al. 2016

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Background: Around 5% of all cutaneous squamous cell carcinoma (cSCC) metastasise. Metastases usually locate in regional skin and lymph nodes, suggesting collective cancer invasion. The cellular level of tumour invasion and prognostic parameters remain to be characterised. Methods: We performed immunohistochemical analyses of E-cadherin (marker for collective cancer invasion) and podoplanin (marker for epithelial-mesenchymal transition [EMT], single-cell invasion) expression in 102 samples of metastatic and non-metastatic cSCC and 18 corresponding skin and lymph node metastases to characterise the invasion of cSCC. Immunohistochemical results were retrospectively correlated with clinical data. Results: E-cadherin was highly expressed in metastatic and non-metastatic cSCC and skin metastases. This suggests collective cancer invasion. However, E-cadherin was downregulated in poorly differentiated cSCC and lymph node metastases, suggesting partial EMT. Podoplanin was significantly upregulated in metastatic (p = 0.002) and poorly differentiated (p = 0.003) cSCC. Overexpression of podoplanin represented a statistically independent prognostic factor for disease-free survival (p = 0.014). Conclusion: Collective cancer invasion is likely in cSCC. In lymph node metastases and poorly differentiated cSCC, partial EMT is possible. Podoplanin is an independent prognostic parameter for metastasis.

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confidence: 99%

Characterisation of Prognosis and Invasion of Cutaneous Squamous Cell Carcinoma by Podoplanin and E-Cadherin Expression

et al. 2016

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“…These data are consistent with our study. We found some differences in the patient characteristics of both groups, which are intrinsic to the epidemiology of the type of tumor: patients with SCC are older than patients with BCC (mean age of debut 70 years vs. 63 years); SCC is more frequent in male than in female patients; and SCC is more frequent in immunosuppressed patients …”

Section: Discussionmentioning

confidence: 86%

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

et al. 2018

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Background The two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors. Objective We aim to compare the characteristics of the patients, the tumors, and MMS, and first‐year follow‐up of MMS in BCC and SCC. Methods REGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow‐up was done with two visits: the first visit within 1 month after surgery and the second one within the first year. Results From July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first‐year follow‐up in the SCC group. Conclusion There are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.

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“…In this setting, regarding its well-established efficacy in BCC and SCC external beam RT appears to be an appropriate treatment option for such patients. [9,10] To our best information, this is the first report on successful treatment of TLC with RT. We decided to prescribe 50 Gy (2 Gy/fr) in view of the way that it is in the commonly practiced total dose (45-50 Gy) and fractionation (1.8-2 Gy) ranges recommended for any tumor type with microscopically positive margin(s).…”

Section: Discussionmentioning

confidence: 88%

Adjuvant radiotherapy in management of trichilemmal carcinoma of left nasal alae with positive surgical margins: A case report

Topkan

Güler

Bal

et al. 2016

CRCP

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Background: Trichilemmal carcinoma (TLC) is a rare adnexal malignant tumor developing from the outer root sheath of hair follicles with no distinct clinical features which might clinically be misdiagnosed as actinic keratosis, nodular melanoma, basal or squamous cell carcinoma. Albeit no consensus exists on standard treatment of TLC, tumor excision with adequate clear margins is the current widely accepted treatment consideration with no previous literature on use of radiotherapy (RT) in definitive or postoperative settings. Case presentation: A 60-year-old woman who was repeatedly treated with cryotherapy located on her left nasal alae for an initial diagnosis of actinic keratosis and diagnosed as TLC at last surgery was referred for RT of microscopic surgical margins. The patient was treated with 6 MeV electron beam RT prescribed to surgical bed plus 1-cm margins at all directions, namely the planning target volume. The total and per fraction doses were 60 and 2 Gy, respectively, which is commonly practiced for any skin tumor with positive margins. The treatment was well tolerated with no acute or chronic complications. The patient was alive with no local, regional, or distant recurrences at the 49 months of her follow-up. Conclusions: Although the follow-up period is relatively short and further evidence is needed to confirm the exact role of RT in adjuvant treatment of TLC, the outcomes of present rare case of a nasal TLC suggests that adjuvant RT in patients with positive surgical margins may provide satisfactory local tumor control.

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Squamous cell carcinoma of the skin: epidemiology, classification, management, and novel trends

Cited by 208 publications

References 73 publications

Characterisation of Prognosis and Invasion of Cutaneous Squamous Cell Carcinoma by Podoplanin and E-Cadherin Expression

Characterisation of Prognosis and Invasion of Cutaneous Squamous Cell Carcinoma by Podoplanin and E-Cadherin Expression

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Adjuvant radiotherapy in management of trichilemmal carcinoma of left nasal alae with positive surgical margins: A case report

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