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Tumor depth tied to recurrence, metastasis of cutaneous SCC
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Tumor depth was a significant risk factor for recurrence and metastasis of cutaneous squamous cell carcinoma, and a tumor diameter of more than 20 mm was a risk factor for disease-specific death, according to a results of a meta-analysis recently published in JAMA Dermatology.
Researchers at the Mayo Clinic, Rochester, Minnesota, conducted a literature search of Ovid Medline In-Process & Other Non-Indexed Citations, Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Scopus from database inception through May 14, 2015. Studies with at least 10 patients, comparative data for at least one cutaneous squamous cell carcinoma (SCC) and “an outcome of interest,” were included.
Data were independently abstracted by two reviewers, and a meta-analysis was performed.
There were 36 studies, including 17,248 patients with 23,421 cutaneous SCCs, included in the analysis.
Breslow thickness exceeding 2 mm (risk ratio [RR] = 9.64; 95% CI, 1.3-71.52), invasion beyond subcutaneous fat, Breslow thickness exceeding 6 mm, perineural invasion, diameter exceeding 20 mm and poor differentiation were significant risk factors for recurrence.
Invasion beyond subcutaneous fat (RR = 11.21; 95% CI, 3.59-34.97), Breslow thickness exceeding 2 mm, perineural invasion, immunosuppression and location on the temple, ear or lip were significant risk factors for metastasis.
Disease-specific death significant risk factors included diameter exceeding 20 mm (RR = 19.1; 95% CI, 5.89-62.95) poor differentiation, location on the ear or lip, invasion beyond subcutaneous fat and perineural invasion.
There was low-to-moderate evidence quality.
“These results verity the significance of many previously reported factors, while providing a robust quantitative risk for each risk factor and associated outcomes of local recurrence, metastasis and death,” the researchers concluded.
“In the short term, these results may help guide physicians in their risk assessment of patients, particularly those with only one identified risk factor, while keeping in mind the inherent limitations of the data. In the long term, these results may be used to refine the evolving work on staging systems for [cutaneous] SCC, while providing a renewed call to action for data collection.” – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.
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