The impact of routine ultrasonography on nodal metastasis in head and neck cutaneous squamous cell carcinoma: A retrospective multicentre cohort study

Eggermont, C; Nené, Lauren Eleanor Hilary; Koekelkoren, Fabiënne H. J.; Toorn, Y R van der; Snetselaar, L D; Kroah-Hartman, M; Genders, Roel E.; Kelleners‐Smeets, Nicole W.J.; Hollestein, Loes; Kester, Marloes S. van; Wakkee, Marlies

doi:10.1111/jdv.19150

Cited by 3 publications

(3 citation statements)

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“…BWH T1 and T2a tumors lack the clinical factors, or a number of clinical factors, that are considered very high risk within the framework of this staging system but can occur in the setting of other high-risk features, including those identified as high risk or very high risk by NCCN guidelines (e.g., location on the head or neck, immunosuppression and LVI, among others) that are clinically concerning and confer eligibility for 40-GEP testing. Risk assessment in these lower staged subsets is important because as many as one-third of all metastatic events in cSCC patients have been observed in T1-staged patients alone because of the high denominator of patients diagnosed with T1 tumors [ 28 ]. Within this study, patients with BWH T1 or T2a tumors and Class 1 results experienced low event rates compared to patients with Class 2A or Class 2B tumors.…”

Section: Discussionmentioning

confidence: 99%

Integrating the 40-Gene Expression Profile (40-GEP) Test Improves Metastatic Risk-Stratification Within Clinically Relevant Subgroups of High-Risk Cutaneous Squamous Cell Carcinoma (cSCC) Patients

Wysong,

Somani,

Ibrahim

et al. 2024

Dermatol Ther (Heidelb)

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Introduction The validated 40-gene expression profile (40-GEP) test independently stratifies risk of regional or distant metastasis for cutaneous squamous cell carcinoma (cSCC) tumors with high-risk clinicopathologic features. This study evaluated the stratification of risk by the 40-GEP test in a large cohort of tumors with one or more high-risk factors and in clinically relevant subgroups, including tumors within National Comprehensive Cancer Network (NCCN) high- and very-high-risk groups, lower-stage BWH T1 and T2a tumors, and patients > 65 years old. Methods This multicenter ( n = 58) performance study of the 40-GEP included 897 patients. Kaplan-Meier analyses were performed to assess risk stratification profiles for 40-GEP Class 1 (low), Class 2A (higher) and Class 2B (highest) risk groups, while nested Cox regression models were used to compare risk prediction of clinicopathologic risk classification systems versus risk classification systems in combination with 40-GEP. Results Patients classified as 40-GEP Class 1, Class 2A, or Class 2B had significantly different metastatic risk profiles ( p < 0.0001). Integrating 40-GEP results into models with individual clinicopathologic risk factors or risk classification systems (Brigham and Women’s Hospital, American Joint Committee on Cancer Staging Manual, 8th Edition) and NCCN demonstrated significant improvement in accuracy for prediction of metastatic events (ANOVA for model deviance, p < 0.0001 for all models). Conclusion The 40-GEP test demonstrates accurate, independent, clinically actionable stratification of metastatic risk and improves predictive accuracy when integrated into risk classification systems. The improved accuracy of risk assessment when including tumor biology via the 40-GEP test ensures more risk-aligned, personalized patient management decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-024-01111-5.

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Section: Discussionmentioning

confidence: 99%

Integrating the 40-Gene Expression Profile (40-GEP) Test Improves Metastatic Risk-Stratification Within Clinically Relevant Subgroups of High-Risk Cutaneous Squamous Cell Carcinoma (cSCC) Patients

Wysong,

Somani,

Ibrahim

et al. 2024

Dermatol Ther (Heidelb)

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“…However, it is well established that tumors with higher T scores in staging systems have a higher risk of LNM [28], and there are studies suggesting that early detection of LNM when fewer lymph nodes are affected [125], or where nodes are smaller and there is no extracapsular invasion [126], may lead to a better prognosis. Some studies have shown a trend towards larger lymph nodes in patients with clinically detected LNM compared to those routinely screened with ultrasound [127].…”

Section: Imaging Approach 61 the Role Of Imaging In Diagnosis And Sta...mentioning

confidence: 99%

“…Despite these recommendations, it is essential to consider that some studies have demonstrated that with a screening ultrasound investigation at baseline, only a few LNM are detected, while the majority of metastases are identified through clinical examination, typically self-examination, during follow-up [127]. This limitation reduces the utility of the technique and raises questions about the appropriate timing of routine ultrasound.…”

Section: Follow-upmentioning

confidence: 99%

Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Verdaguer-Faja,

Toll,

Boada

et al. 2024

Cancers

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Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic thickness and anatomical structure that may influence both growth pattern and treatment of primary cSCC; while clinical peripheral margins may be easily achieved during the surgery, vertical excision of the tumor is limited by the skull. Despite having a unique anatomy, current guidelines do not contemplate specific recommendations for scalp cSCC, which leads to inconsistent decision-making in multidisciplinary committees when discussing tumors with high risk factors or with close margins. This article provides specific recommendations for the management of patients with scalp cSCC, based on current evidence, as well as those aspects in which evidence is lacking, pointing out possible future lines of research. Topics addressed include epidemiology, clinical presentation and diagnosis, imaging techniques, surgical and radiation treatments, systemic therapy for advanced cases, and follow-up. The primary focus of this review is on management of primary cSCC of the scalp with localized disease, although where relevant, some points about recurrent cSCCs or advanced disease cases are also discussed.

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Cutaneous Squamous Cell Carcinoma: From Diagnosis to Follow-Up

Comune,

Ruggiero,

Portarapillo

et al. 2024

Cancers

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Cutaneous squamous cell carcinoma (SCC) is the second most frequent skin cancer, accounting for approximately 20% of all cutaneous malignancies, and with an increasing incidence due to the progressive increment of the average age of life. The diagnosis is usually firstly suspected based on clinical manifestations; however, dermoscopic features may improve diagnostic sensitivity in cases of an uncertain diagnosis and may guide the biopsy, which should be performed to histopathologically prove the tumor. New diagnostic strategies may improve the sensitivity of the cutaneous SCC, such as reflectance confocal microscopy and line-field confocal optical coherence, for which increasing data have been recently published. Imaging has a central role in the staging of the diseases, while its exact role, as well as the choice of the best techniques, during the follow-up are not fully clarified. The aim of this literature review is to describe diagnostic clinical and instrumental tools of cutaneous SCC, with an insight into the role of imaging in the diagnosis and follow-up of cutaneous SCC.

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The impact of routine ultrasonography on nodal metastasis in head and neck cutaneous squamous cell carcinoma: A retrospective multicentre cohort study

Cited by 3 publications

References 5 publications

Integrating the 40-Gene Expression Profile (40-GEP) Test Improves Metastatic Risk-Stratification Within Clinically Relevant Subgroups of High-Risk Cutaneous Squamous Cell Carcinoma (cSCC) Patients

Integrating the 40-Gene Expression Profile (40-GEP) Test Improves Metastatic Risk-Stratification Within Clinically Relevant Subgroups of High-Risk Cutaneous Squamous Cell Carcinoma (cSCC) Patients

Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches

Cutaneous Squamous Cell Carcinoma: From Diagnosis to Follow-Up

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