TY - JOUR
T1 - Mortality risk from squamous cell skin cancer
AU - Clayman, Gary L.
AU - Lee, Jack J.
AU - Holsinger, F. Christopher
AU - Zhou, Xian
AU - Duvic, Madeleine
AU - El-Naggar, Adel K.
AU - Prieto, Victor G.
AU - Altamirano, Evelyn
AU - Tucker, Susan L.
AU - Strom, Sara S.
AU - Kripke, Margaret L.
AU - Lippman, Scott M.
PY - 2005
Y1 - 2005
N2 - Purpose: To identify nonmelanoma skin cancer patients with squamous cell carcinoma (SCO who are at greatest risk of disease-specific mortality. Patients and Methods: Prospectively enrolled patients with a minimum of one pathologically confirmed skin SCC lesion, definitive treatment of the SCC lesion(s) resulting in no evidence of disease, and at least 2 months of follow-up after definitive treatment were eligible for the present longitudinal analysis. They received comprehensive clinical, pathologic evaluations and follow-up for patterns of failure and mortality. Results: We enrolled 210 patients (187 men and 23 women) with a total of 277 skin SCC lesions and a median enrollment age of 68 years (range, 34 to 95 years). Median follow-up of surviving patients was 22 months. Three-year overall and disease-specific survival (DSS) rates were 70% and 85%, respectively. In univariate analyses, the clinical-pathologic factors associated with adverse DSS were local recurrence at presentation (P = .05), invasion beyond subcutaneous tissues (P = .009), perineural invasion (P = .002), lesion size (P = .0003), and depth of invasion (P = .05). Statistical models identified a homogeneous high-risk group of patients with lesions & 4 cm, perineural invasion, and deep invasion beyond subcutaneous structures. Three-year DSS was 100% for patients with no risk factors versus 70% for patients with at least one risk factor. Conclusion: Lesion size ≥ 4 cm and histologic evidence of perineural invasion and deep invasion beyond subcutaneous structures were the clinical-pathologic factors most significantly associated with disease-specific mortality in skin SCC.
AB - Purpose: To identify nonmelanoma skin cancer patients with squamous cell carcinoma (SCO who are at greatest risk of disease-specific mortality. Patients and Methods: Prospectively enrolled patients with a minimum of one pathologically confirmed skin SCC lesion, definitive treatment of the SCC lesion(s) resulting in no evidence of disease, and at least 2 months of follow-up after definitive treatment were eligible for the present longitudinal analysis. They received comprehensive clinical, pathologic evaluations and follow-up for patterns of failure and mortality. Results: We enrolled 210 patients (187 men and 23 women) with a total of 277 skin SCC lesions and a median enrollment age of 68 years (range, 34 to 95 years). Median follow-up of surviving patients was 22 months. Three-year overall and disease-specific survival (DSS) rates were 70% and 85%, respectively. In univariate analyses, the clinical-pathologic factors associated with adverse DSS were local recurrence at presentation (P = .05), invasion beyond subcutaneous tissues (P = .009), perineural invasion (P = .002), lesion size (P = .0003), and depth of invasion (P = .05). Statistical models identified a homogeneous high-risk group of patients with lesions & 4 cm, perineural invasion, and deep invasion beyond subcutaneous structures. Three-year DSS was 100% for patients with no risk factors versus 70% for patients with at least one risk factor. Conclusion: Lesion size ≥ 4 cm and histologic evidence of perineural invasion and deep invasion beyond subcutaneous structures were the clinical-pathologic factors most significantly associated with disease-specific mortality in skin SCC.
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U2 - 10.1200/JCO.2005.02.155
DO - 10.1200/JCO.2005.02.155
M3 - Article
C2 - 15681519
AN - SCOPUS:20044364934
SN - 0732-183X
VL - 23
SP - 759
EP - 765
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 4
ER -