This article is more than 5 years old. Information may no longer be current.

Aggressive squamous cell carcinoma predicted by immunosuppression, cigarette use

Researchers from the University of California, San Diego found that incidence of squamous cell carcinoma with an aggressive subclinical extension can be predicted by factors such as immunosuppression and cigarette use.

“[Squamous cell carcinomas with aggressive subclinical extension] are frequently missed with traditional diagnostic techniques, leading to inappropriate surgical margin selection, unanticipated treatment durations and possible lesion recurrence or metastasis,” Alina Goldenberg, MAS, and colleagues wrote in their study. “Our data and predictive model suggest that clinical factors, especially immunosuppression and cigarette use status, can help predict the occurrence of [squamous cell carcinomas with aggressive subclinical extension] and thereby optimize surgical planning and patient preparedness.”

Goldenberg and colleagues performed a retrospective analysis of 954 cases involving patients with squamous cell carcinoma (SCC) who underwent Mohs micrographic surgery between 2007 and 2012. The researchers defined aggressive subclinical extension for SCC as surgical margins of 1 cm and higher and three or more Mohs stages.

They found that 32% of cases contained aggressive subclinical extension, with men having 2.2 times the odds of developing aggressive subclinical extension SCC compared with women. In an adjusted analysis, current cigarette use (OR = 4.7; 95% CI, 3.3-6.6), a history of previous non-melanoma skin cancer (OR = 1.9; 95% CI, 1.3-2.6), immunosuppression related to organ transplant (OR = 1.7; 95% CI, 1.3-2.2), and Fitzpatrick skin type II (OR = 0.7; 95% CI, 0.6-0.9) and type III (OR = 0.6; 95% CI, 0.5-0.8) were associated with increased incidence of SCC with aggressive subclinical extension.

Disclosure: The researchers report no relevant financial