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Risk factors for metastatic cutaneous squamous cell carcinoma: Refinement and replication based on 2 nationwide

Selin Tokez1, Zoe C Venables2, Loes M Hollestein3

  • 1Department of Dermatology, Erasmus Medical Center Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Journal of the American Academy of Dermatology
|March 8, 2022
PubMed
Summary

This study identified key risk factors for cutaneous squamous cell carcinoma (cSCC) metastasis, including poor differentiation and tumor invasion. Incorporating these factors can improve cSCC staging and patient outcomes.

Keywords:
cutaneous squamous cell carcinomametastasisprognosisreplicationrisk factors

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Area of Science:

  • Oncology
  • Dermatology
  • Cancer Research

Background:

  • Investigating risk factors for cutaneous squamous cell carcinoma (cSCC) metastasis is crucial, but previous studies used limited data.
  • Understanding metastasis predictors aids in developing more effective treatment and staging strategies for cSCC.

Purpose of the Study:

  • To analyze and replicate risk factors associated with metastatic cutaneous squamous cell carcinoma (cSCC).
  • To enhance current staging systems for cSCC by identifying significant prognostic indicators.

Main Methods:

  • A matched case-control study utilizing nationwide cancer registry data from England and the Netherlands.
  • Variables were extracted from pathology reports and histopathologic slides, with model building in English data and replication in Dutch data using logistic regression.

Main Results:

  • Significant risk factors for metastatic cSCC included poor differentiation, subcutaneous fat invasion, male sex, perineural/lymphovascular invasion, and facial tumor location.
  • Tumor diameter and thickness demonstrated nonlinear relationships with metastasis.
  • Findings were validated across both English and Dutch cohorts, confirming the robustness of the identified risk factors.

Conclusions:

  • Current cSCC staging systems can be improved by integrating differentiation, clinical characteristics (sex, location), and nonlinear tumor dimensions.
  • The identified factors provide valuable insights for risk stratification and personalized management of cSCC patients.