Factors associated with inoperable cutaneous squamous cell carcinoma

Area of Science:

• Dermatology
• Oncology
• Public Health

Background:

• Inoperable cutaneous squamous cell carcinomas (SCCs) are rare but life-threatening, with limited research on contributing factors.
• Understanding these factors is crucial for improving patient outcomes and management strategies.

Purpose of the Study:

• To identify factors associated with inoperable SCCs, including patient and tumor characteristics.
• To investigate care pathway-related factors contributing to advanced SCCs.

Main Methods:

• An observational retrospective study compared 73 cases of inoperable SCCs with 73 operable SCC cases at Reims University Hospital.
• Data collected included patient demographics, tumor characteristics, clinical history, and care pathway details.

Main Results:

• Patients with inoperable SCCs were older and had higher rates of comorbidities (dementia, cardiovascular disease) and poorly differentiated tumors.
• Significant delays in diagnosis and treatment, patient/family reluctance, and lack of surgical revision were identified as modifiable factors.
• Median overall survival for inoperable SCCs was 7.6 months, with a 3-year survival rate below 5%.

Conclusions:

• Older age, comorbidities, and tumor differentiation are associated with inoperable SCCs.
• Modifiable factors in the care pathway, including delays and patient/family non-adherence, significantly impact SCC progression.
• Enhanced patient and physician education on SCC severity and timely management is essential, particularly for elderly and frail individuals.