Staging for Cutaneous Squamous Cell Carcinoma as a Predictor of Sentinel Lymph Node Biopsy Results

Schmitt, Alessandra C.; Brewer, Jerry D.; Bordeaux, Jeremy S.; Baum, Christian L.

doi:10.1001/jamadermatol.2013.6675

Cited by 119 publications

(35 citation statements)

References 49 publications

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“…The majority of positive SLNBs were AJCC T2 stage tumors (13 out of 116 SLNs; 11.2%) and BWH stage T2b tumors (5 out of 17 SLNs; 29.4%) while no AJCC or BWH stage T1 and only 6 out of 85 (7.1%) BWH stage T2a tumors had a positive SLN. Although more data is needed, the rate of positive SLNB in BWH stage T2b tumors far exceeds the 10% rate threshold for SLNB in malignant melanoma (66). A recent systematic review reported the rate of positive SLNB in CSCC patients as 13.9% (32 out of 231 patients) with a false negative rate of 4.6% (10 out of 215 patients).…”

Section: Sentinel Lymph Node Biopsy (Slnb)mentioning

confidence: 99%

A Review of Cutaneous Squamous Cell Carcinoma Epidemiology, Diagnosis, and Management

2018

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Introduction: Cutaneous squamous cell carcinoma (CSCC) is the second most common type of skin cancer and its incidence continues to rise worldwide. While the majority of CSCCs have excellent prognosis, a subset have the propensity to cause poor outcomes. Evidence Acquisition: A thorough Pubmed search was done and a collection of CSCC-relevant articles were selected based on the expert opinion. Results: A number of high-risk factors have been identified including perineural invasion (PNI), desmoplastic growth pattern, poor differentiation, high risk location and large diameter. Various staging systems have been developed based on these high-risk factors. Radiologic imaging is important for high-stage tumors and is likely associated with more aggressive management. Conclusions: Although surgical management is the gold standard, newer therapies such as programmed cell death protein-1 (PD-1) inhibitors show promise for locally advanced or metastatic disease. Despite advances in treatment, early diagnosis and prevention of CSCC is still the most important measure to ensure good outcomes.

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Section: Sentinel Lymph Node Biopsy (Slnb)mentioning

confidence: 99%

A Review of Cutaneous Squamous Cell Carcinoma Epidemiology, Diagnosis, and Management

2018

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“…This number rises to 50.0% when four risk factors are present. 27 In a recent systematic review, the authors successfully demonstrated the feasibility and reliability of SLNB for accurate staging of head and neck SCCS patients with a false omission rate of only 4.76%, similar to the experience with melanoma. 2 Indeed, SLNB use may improve survival rates in SCCS, not only by identifying subclinical lymph node involvement but by locating the correct draining nodal basin, which would guide directed therapy at an earlier and potentially more curable point of regional metastatic spread.…”

Section: Surgical Managementmentioning

confidence: 61%

Developments in the Treatment of Locally Advanced and Metastatic Squamous Cell Carcinoma of the Skin: A Rising Unmet Need

Palyca

Koshenkov

Mehnert

2014

American Society of Clinical Oncology Educational Book

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Squamous cell carcinoma of the skin (SCCS) is a common malignancy with potentially devastating consequences in patients with locally advanced or metastatic disease. Its rising incidence, primarily a result of an aging population and increased ultraviolet (UV) radiation exposure, characterize an emerging unmet need. A firm understanding of the biology of this disease, likely distinct from that of other squamous malignancies because of the influence of UV radiation, is necessary in the evaluation of treatment paradigms. Careful recognition of high-risk features pertaining to tumor and host characteristics is paramount to proper management. However, a lack of standardization in guidelines in this regard creates a challenge for physicians. Questions persist regarding additional evaluation and treatment for advanced disease such as the roles for sentinel lymph node biopsy and the adjuvant use of radiation and chemotherapy. With respect to advanced disease, multiple combinations of chemotherapy have been tested with variable success, but no rigorous randomized studies have been conducted. In addition, EGFR inhibitors such as cetuximab and erlotinib have displayed antitumor activity and as such, warrant further investigation. In sum, the treatment of locally advanced and metastatic SCCS is a ripe area for clinical investigation. This article summarizes the current understanding of disease biology and emerging questions in the management of this disease.

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Section: Work Upmentioning

confidence: 99%

“…Of those cSCCs that metastasize, 80% involve regional lymph nodes [5,25,27]. CSCCs can also metastasize to distant sites including the lungs, liver, brain, bones, and other cutaneous locations [27,28]. The risk factors most often associated with metastasis include perineural invasion, recurrence after treatment, size greater than 2 cm, and poorly differentiated histology [6,29].…”

Section: Work Upmentioning

confidence: 99%

“…A recent study to evaluate which stages of the AJCC and BWH alternative staging systems were associated with positive sentinel lymph node biopsy (SLNB) findings in non-anogenital cSCC found that positive SNLBs were more likely in T2 lesions of both staging systems, with a greater risk in lesions larger than 2 cm [27]. However, the rate of positive SNLB was statistically higher in T2b lesions than T2a lesions of the BWH system, suggesting that the BWH system appears more precise in delineating which high-risk lesions would warrant SNLB [27]. Other studies have shown excellent negative predictive values for SLNB for cSCCs ranging from 95.2 to 100% and suggest that SLNB may be of value to rule out nodal metastases [33].…”

Section: Role Of Nodal Biopsymentioning

confidence: 99%

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Advances in the management of cutaneous squamous cell carcinoma

Parikh¹,

Patel²,

Ratner³

2014

F1000Prime Rep

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Cutaneous squamous cell carcinoma is one of the most common non-melanoma skin cancers worldwide. While most cutaneous squamous cell carcinomas are easily managed, there is a high-risk subset of tumors that can cause severe morbidity and mortality. Tumor characteristics as well as patient characteristics contribute to the classification of cutaneous squamous cell carcinomas as low-risk vs. high-risk. Advances in the treatment of cutaneous squamous cell carcinomas largely relate to the management of this high-risk subset. Surgical and non-surgical management options, including newer targeted molecular therapies, will be discussed here. Larger, multicenter studies are needed to determine the exact significance of individual risk factors with respect to aggressive clinical behavior and the risks of metastasis and death, as well as the role of surgical and adjuvant therapies in patients with high-risk cutaneous squamous cell carcinomas.

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Staging for Cutaneous Squamous Cell Carcinoma as a Predictor of Sentinel Lymph Node Biopsy Results

Cited by 119 publications

References 49 publications

A Review of Cutaneous Squamous Cell Carcinoma Epidemiology, Diagnosis, and Management

A Review of Cutaneous Squamous Cell Carcinoma Epidemiology, Diagnosis, and Management

Developments in the Treatment of Locally Advanced and Metastatic Squamous Cell Carcinoma of the Skin: A Rising Unmet Need

Advances in the management of cutaneous squamous cell carcinoma

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