Surgical management of cutaneous squamous cell carcinoma of the headand neck

Baker, Nicholas; Webb, A.A.C.; Macpherson, D.W.

doi:10.1054/bjom.2000.0584

Cited by 47 publications

(58 citation statements)

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“…551 Rank 1973 542 Shiu 1980 549 Fitzpatrick 1985 552 Reifler 1986 548 Baker 2001 541 Griffiths 2002 Sensitivity analysis of the four papers meeting our criteria for studies at lowest risk of bias had no significant effect on local recurrence (4.2%, 95% CI 0.6% to 10.8%; I 2 = 81.4%). [544][545][546]550 Recurrence in regional lymph nodes after surgical excision of SCC was reported in eight series (comprising 786 patients), ranging from 0% to 9.7%, 541,543,545,547,548,550,551,553 with pooled average recurrence of 4.4% (95% CI 2.4 to 6.9; I 2 = 50%) (see Figure 31). Sensitivity analysis in which only the three papers considered at lowest risk of bias were included had no significant effect on regional recurrence (4.6%, 95% CI 1.3% to 10.0%; I 2 = 72%).…”

Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 98%

“…Local recurrence during follow-up after surgical excision ranged from 0% to 15%, [541][542][543][544][545][546][547][548][549][550][551][552] with an estimated overall pooled recurrence of 5.4% (95% CI 2.5 to 9.1; I 2 = 81%) ( Figure 28). …”

Section: Surgical Excisionmentioning

confidence: 99%

“…545 In those studies with mean follow-up of between 2 and 5 years (736 patients), recurrence ranged from 0% to 13.0%, with a pooled estimate of recurrence of 5.0% (95% CI 2.3 to 8.3; I 2 = 62%). [541][542][543][546][547][548]550,552 One of the 12 studies had a minimum follow-up period of 5 years and reported no local recurrences of 86 surgically excised SCCs at various sites. 544 Three studies reported recurrence of 4.8% for eyelid SCCs, 552 10.5% for trunk and extremity SCCs 549 and 15.3% for SCCs of the pinna 551 ( Figure 29), but did not specify for how long patients were followed.…”

Section: Surgical Excisionmentioning

confidence: 99%

“…Three studies (n = 261) in which SCCs of the pinna were surgically excised gave a pooled average local recurrence of 14.1% (95% CI 10.2 to 18.5; I 2 = 0%), 547,550,551 compared with a significantly lower pooled average of 3.2% (95% CI 1.5 to 5.5; I 2 = 57%) for the studies (n = 916) in which SCCs at other sites were included (Figures 30 and 31). [541][542][543][544][545][546]548,549,552 A non-significant tendency for increased local recurrence with increasing SCC diameter was noted in one series, with local recurrences in 12.2% (95% CI 4.6% to 24.7%) of the 49 lesions < 10 mm in diameter, 14.3% (95% CI 7.8% to 23.2%) of the 91 lesions 10-30 mm in diameter, 21.7% (95% CI 7.4% to 43.7%) of 23 lesions 30-40 mm in diameter, and 42.8% (95% CI 9.9% to 81.6%) of the seven tumours > 40 mm in diameter. 551 Rank 1973 542 Shiu 1980 549 Fitzpatrick 1985 552 Reifler 1986 548 Baker 2001 541 Griffiths 2002 Sensitivity analysis of the four papers meeting our criteria for studies at lowest risk of bias had no significant effect on local recurrence (4.2%, 95% CI 0.6% to 10.8%; I 2 = 81.4%).…”

Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 99%

“…[541][542][543][544][545][546]548,549,552 A non-significant tendency for increased local recurrence with increasing SCC diameter was noted in one series, with local recurrences in 12.2% (95% CI 4.6% to 24.7%) of the 49 lesions < 10 mm in diameter, 14.3% (95% CI 7.8% to 23.2%) of the 91 lesions 10-30 mm in diameter, 21.7% (95% CI 7.4% to 43.7%) of 23 lesions 30-40 mm in diameter, and 42.8% (95% CI 9.9% to 81.6%) of the seven tumours > 40 mm in diameter. 551 Rank 1973 542 Shiu 1980 549 Fitzpatrick 1985 552 Reifler 1986 548 Baker 2001 541 Griffiths 2002 Sensitivity analysis of the four papers meeting our criteria for studies at lowest risk of bias had no significant effect on local recurrence (4.2%, 95% CI 0.6% to 10.8%; I 2 = 81.4%). [544][545][546]550 Recurrence in regional lymph nodes after surgical excision of SCC was reported in eight series (comprising 786 patients), ranging from 0% to 9.7%, 541,543,545,547,548,550,551,553 with pooled average recurrence of 4.4% (95% CI 2.4 to 6.9; I 2 = 50%) (see Figure 31).…”

Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 99%

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A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10177. The contractual start date was in September 2008. The final report began editorial review in April 2014 and was accepted for publication in April 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, ...

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Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 98%

Section: Surgical Excisionmentioning

confidence: 99%

Section: Surgical Excisionmentioning

confidence: 99%

Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 99%

Section: Squamous Cell Skin Cancer Work Programmementioning

confidence: 99%

See 3 more Smart Citations

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Risk Factors for Cutaneous Squamous Cell Carcinoma Recurrence, Metastasis, and Disease-Specific Death

et al. 2016

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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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Surgical management of cutaneous squamous cell carcinoma of the headand neck

Cited by 47 publications

References 10 publications

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Risk Factors for Cutaneous Squamous Cell Carcinoma Recurrence, Metastasis, and Disease-Specific Death

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

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