Surgery for Cutaneous Squamous Cell Carcinoma and its Limits in Advanced Disease

Moreno‐Ramírez, D.; Silva-Clavería, Francisca; Fernández‐Orland, Almudena; Eirís, Noemí; Ruíz-de-Casas, A.; Ferrándiz, Lara

doi:10.5826/dpc.11s2a167s

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…The risk of postoperative complications is high in elderly patients, with large postoperative defects and difficult wound healing. The poor mobility and weakness of the elderly make regular follow-up more difficult and the prognosis worse ( 25 , 49 ).…”

Section: Discussionmentioning

confidence: 99%

Trends in cutaneous squamous cell carcinoma on the lip incidence and mortality in the United States, 2000–2019

Zhang

Yang

et al. 2023

Front. Oncol.

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ObjectiveThis study provided a systematic analysis of the trend in incidence and incidence-based mortality for cutaneous squamous cell carcinoma (cSCC) on the lips in the USA using demographic characteristics from the Surveillance, Epidemiology, and End Results (SEER) database.MethodsPatients diagnosed with cSCC on the lips between 2000 and 2019 from the 17 registries of the USA were identified. Incidence and incidence-based mortality rates were analyzed using SEER*Stat 8.4.0.1 software. This paper calculated incidence rates and incidence-based mortality rates by 100,000 person-years for sex, age, race, SEER registries, median household income ($/year), rural-urban distribution, and primary site. The annual percent changes (APC) in incidence and incidence-based mortality rates were then calculated using joinpoint regression software.ResultsAmong 8,625 patients diagnosed with cSCC on the lips from 2000 to 2019, men (74.67%), white (95.21%), and 60–79 years old were the most common population, and 3,869 deaths from cSCC on the lips occurred. The overall incidence of cSCC on the lips was 0.516 per 100,000 person-years. cSCC on the lip incidence rates were highest among men, white, and patients aged 60–79 years old. cSCC on the lip incidence rates decreased by 3.210%/year over the study period. The incidence of cSCC on the lips has been decreasing in all sexes, ages, high- or low-income households, and urban or rural patients. The overall incidence-based mortality rate of cSCC on the lips during 2000–2019 was 0.235 per 100,000 person-years. cSCC on the lip incidence-based mortality rates were highest among men, whites, and people older than 80 years old. cSCC on the lip incidence-based mortality increased by 4.975%/year over the study period. cSCC on the lip incidence-based mortality rates increased for all sexes, races, ages, primary sites, high- or low-income households, and urban or rural patients during the study period.ConclusionAmong patients in the USA diagnosed with cSCC on the lips from 2000 to 2019, the overall incidence decreased by 3.210% annually, and incidence-based mortality increased by 4.975%/year. These findings update and supplement the epidemiological information of cSCC on the lips in the USA.

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Section: Discussionmentioning

confidence: 99%

Trends in cutaneous squamous cell carcinoma on the lip incidence and mortality in the United States, 2000–2019

Zhang

Yang

et al. 2023

Front. Oncol.

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“…The challenge of consistently defining and identifying primary lesions at high risk of metastasis means investment in effective treatments for metastases is critical 4 . Surgery remains the frontline treatment for metastatic disease, though incomplete excisions and recurrence are frequent 5,6 . Adjuvant radiotherapy remains central in reducing locoregional failure.…”

Section: Introductionmentioning

confidence: 99%

“…4 Surgery remains the frontline treatment for metastatic disease, though incomplete excisions and recurrence are frequent. 5,6 Adjuvant radiotherapy remains central in reducing locoregional failure. Prior to the emergence of immunotherapy, there were no systemic therapeutic options for patients with advanced disease.…”

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confidence: 99%

Ex vivo therapeutic screening of metastatic cSCC: A review of methodological considerations for clinical implementation

Conley,

Perry,

Ashford

et al. 2024

Experimental Dermatology

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Cutaneous squamous cell carcinoma (cSCC) is the second most common malignancy worldwide, with most deaths caused by locally advanced and metastatic disease. Treatment of resectable metastases is typically limited to invasive surgery with adjuvant radiotherapy; however, many patients fail to respond and there is minimal data to predict response or propose effective alternatives. Precision medicine could improve this, though genomic biomarkers remain elusive in the high mutational background and genomic complexity of cSCC. A phenotypic approach to precision medicine using patient‐derived ex vivo tumour models is gaining favour for its capacity to directly assess biological responses to therapeutics as a functional, predictive biomarker. However, the use of ex vivo models for guiding therapeutic selection has yet to be employed for metastatic cSCC. This review will therefore evaluate the existing experimental models of metastatic cSCC and discuss how ex vivo methods could overcome the shortcomings of these existing models. Disease‐specific considerations for a prospective methodological pipeline will also be discussed in the context of precision medicine.

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“…Cutaneous squamous cell carcinoma (cSCC) represents the second most common form of skin cancer, with a continuously increasing incidence, and accounts for around 20% of cutaneous carcinomas [1,2]. Surgery represents the first-line therapeutic option, with the primary aim of achieving complete tumor resection (R0) [3][4][5]. Survival and outcome mostly depend on local recurrence and metastasis [6].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Recurrence and Progression in Poorly Differentiated Cutaneous Squamous Cell Carcinomas: Insights from a Real-Life Experience

Roccuzzo,

Orlando,

Rumore

et al. 2023

Dermatology

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Introduction: Surgery represents the primary treatment option for cutaneous squamous cell carcinoma (cSCC) aiming for complete tumor resection (R0). Recurrence and metastasis significantly affect survival and outcomes, and poorly differentiated (G3) cSCC is associated with a higher risk of recurrence. However, the specific clinical and histopathological features that predict recurrence and progression in G3-cSCC remain unclear. Methods: A retrospective analysis was conducted on a series of patients with primary G3-cSCC diagnosed at the Turin University Hospital between January 2016 and January 2021. After independent histological revision, logistic regression models were used to identify clinico-pathological predictors of cutaneous recurrence, lymphnode/metastatic progression, and both types of progression. Results: Among the 161 G3-cSCC patients, 80.1% (129/161) showed no signs of local recurrence or metastatic progression, while 19.9% (32 patients) had progressed. In the univariate logistic regression, tumor clinical diameter, depth of infiltration (DOI), and lymphovascular invasion (LVI) were identified as significant predictors across the various types of progression (p < 0.05). In the context of multivariate logistic regression, distinct models proved to be significant. For skin recurrence, a 3-variable model incorporating DOI (OR 1.16, 95% CI, 1.01–1.35, p = 0.050), LVI (OR 3.61, 95% CI, 1.11–11.8, p = 0.034), and desmoplasia (OR 3.45, 95% CI, 1.25–9.5, p = 0.017) was selected. Regarding lymphnode/metastatic progression, a 3-variable model combining pT2 (OR 6.10, 95% CI, 1.15–32.35, p = 0.034), pT3 (OR 14.33, 95% CI, 2.79–73.63, p = 0.001), and LVI (OR 3.86, 95% CI, 1.10–13.62, p = 0.036) was identified. Lastly, a 2-variable model for both types of progression consisted of vertical tumor thickness (OR 5.45, 95% CI, 1.11–27.32, p = 0.039) and LVI (OR 1.15, 95% CI, 1.04–1.26, p = 0.006). Conclusion: Tumor size, DOI, and LVI were significant predictors of recurrence and metastatic progression. Notably, the size of histologically defined tumor-free margins did not affect the risk of recurrence, whilst LVI emerged as a key predictor of all forms of progression. These findings provide insights into risk stratification and suggest that close monitoring and potential adjuvant therapies, such as radiation therapy, may be necessary especially for patients with lymphovascular involvement.

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Surgery for Cutaneous Squamous Cell Carcinoma and its Limits in Advanced Disease

Cited by 6 publications

References 40 publications

Trends in cutaneous squamous cell carcinoma on the lip incidence and mortality in the United States, 2000–2019

Trends in cutaneous squamous cell carcinoma on the lip incidence and mortality in the United States, 2000–2019

Ex vivo therapeutic screening of metastatic cSCC: A review of methodological considerations for clinical implementation

Predictors of Recurrence and Progression in Poorly Differentiated Cutaneous Squamous Cell Carcinomas: Insights from a Real-Life Experience

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