Squamous cell carcinomas with LVI have higher metastasis, death rates

A higher rate of metastasis and death occurred in those with cutaneous squamous cell carcinomas with lymphovascular invasion, according to a study.

“Cutaneous squamous cell carcinomas (CSCC) comprise approximately 700,000 of the 3.5 million keratinocyte carcinomas diagnosed in the United States each year,” Kylee J.B. Kus, BS, formerly a clinical research fellow in the department of dermatology at Brigham and Women’s Hospital, and colleagues wrote. “Lymphovascular invasion (LVI), defined as the presence of tumor cells within an endothelial-lined lumen of a lymphatic or vascular vessel, is considered to be a high-risk feature associated with metastatic disease and DSD in patients with CSCC.”

A retrospective, multicenter cohort study looked at features of 10,707 CSCC tumors, including clinical diameter, anatomic depth of invasion, tumor differentiation, anatomic location, presence of perineural invasion or lymphovascular invasion, as well as outcomes of interest and demographic information.

LVI was present in 78 tumors and these had a significantly higher cumulative incidence of local recurrence at 12.3% compared with 1.1% of those that did not have LVI (P < .01).

There was also a significantly higher rate of metastasis (4.2% vs 0.4%; P < .01) and disease specific death (16.2% vs 0.4%; P < .01).

For high-stage tumors, a 5-year cumulative incidence of metastasis was 28.5% in the LVI group compared with 16.8% of those that did not have LVI (P = .06), and the disease related death rate was 25.3% in the LVI group compared with 13.9% (P = .03) in the group without LVI.

“LVI appears to independently influence [local recurrence] and metastasis in low-stage CSCCs and disease related death in all tumors,” the authors wrote. “Future staging systems should consider incorporating LVI as a risk factor, but in the interim, CSCCs with LVI should be considered at high-risk for metastasis and death and managed accordingly.”