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. 2023 Aug;30(8):5017-5026.
doi: 10.1245/s10434-023-13306-9. Epub 2023 Mar 29.

Oncological Outcome After Lymph Node Dissection for Cutaneous Squamous Cell Carcinoma

Eva A Huis In 't Veld #  1   2 , Thomas Boere #  3 , Charlotte L Zuur  3 , Michel W Wouters  4   5 , Alexander C J van Akkooi  4 , John B A G Haanen  6 , Marianne B Crijns  7 , Myles J Smith  8 , Antien Mooyaart  9 , Marlies Wakkee  10 , Aniel Sewnaik  11 , Dirk C Strauss  8 , Dirk J Grunhagen  12 , Cornelis Verhoef  12 , Andrew J Hayes #  8 , Winan J van Houdt #  4
Affiliations

Oncological Outcome After Lymph Node Dissection for Cutaneous Squamous Cell Carcinoma

Eva A Huis In 't Veld et al. Ann Surg Oncol. 2023 Aug.

Abstract

Background: Although cutaneous squamous cell carcinoma (cSCC) is common, lymph node metastases are relatively rare and are usually treated with lymph node dissection (LND). The aim of this study was to describe the clinical course and prognosis after LND for cSCC at all anatomical locations.

Methods: A retrospective search at three centres was performed to identify patients with lymph node metastases of cSCC who were treated with LND. Prognostic factors were identified by uni- and multivariable analysis.

Results: A total of 268 patients were identified with a median age of 74. All lymph node metastases were treated with LND, and 65% of the patients received adjuvant radiotherapy. After LND, 35% developed recurrent disease both locoregionally and distantly. Patients with more than one positive lymph node had an increased risk for recurrent disease. 165 (62%) patients died during follow-up of whom 77 (29%) due to cSCC. The 5-year OS- and DSS rate were 36% and 52%, respectively. Disease-specific survival was significantly worse in immunosuppressed patients, patients with primary tumors >2cm and patients with more than one positive lymph node.

Conclusions: This study shows that LND for patients with lymph node metastases of cSCC leads to a 5-year DSS of 52%. After LND, approximately one-third of the patients develop recurrent disease (locoregional and/or distant), which underscores the need for better systemic treatment options for locally advanced cSCC. The size of the primary tumor, more than one positive lymph node, and immunosuppression are independent predictors for risk of recurrence and disease-specific survival after LND for cSCC.

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Conflict of interest statement

Eva A. Huis in ’t Veld, Thomas Boere, Charlotte L. Zuur, Michel W. Wouters, Alexander C.J. van Akkooi, John B.A.G. Haanen, Marianne B. Crijns, Myles J. Smith, Antien Mooyaart, Marlies Wakkee, Aniel Sewnaik, Dirk C. Strauss, Dirk J. Grunhagen, Cornelis Verhoef, Andrew J. Hayes, and Winan J. van Houdt have no potential conflicts of interest to declare. Funding This study did not receive any financial or material support.

Figures

Fig. 1
Fig. 1
Kaplan Meier curves of recurrence free survival and disease specific survival, patients are classified according to the number of positivie lymph nodes, immunosuppression status and size of the primary tumor. All Kaplan Meier curves are based on non imputated data. LND = lymph node dissection
See this image and copyright information in PMC

References

    1. Ribero S, Stucci LS, Daniels GA, Borradori L. Drug therapy of advanced cutaneous squamous cell carcinoma: is there any evidence? Curr Opin Oncol. 2017;29(2):129–135. doi: 10.1097/CCO.0000000000000359. - DOI - PubMed
    1. Rogers HW, Weinstock MA, Feldman SR. Coldiron BM 2012 incidence estimate of nonmelanoma skin cancer (Keratinocyte Carcinomas) in the US population. JAMA Dermatol. 2015;151(10):1081–1086. doi: 10.1001/jamadermatol.2015.1187. - DOI - PubMed
    1. Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166(5):1069–1080. doi: 10.1111/j.1365-2133.2012.10830.x. - DOI - PubMed
    1. Lansbury L, Bath-Hextall F, Perkins W, Stanton W, Leonardi-Bee J. Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies. BMJ. 2013;347:f6153. doi: 10.1136/bmj.f6153. - DOI - PMC - PubMed
    1. Brougham ND, Dennett ER, Cameron R, Tan ST. The incidence of metastasis from cutaneous squamous cell carcinoma and the impact of its risk factors. J Surg Oncol. 2012;106(7):811–815. doi: 10.1002/jso.23155. - DOI - PubMed