Oncological Outcome After Lymph Node Dissection for Cutaneous Squamous Cell Carcinoma.

Area of Science:

• Oncology
• Dermatology
• Surgical Oncology

Background:

• Cutaneous squamous cell carcinoma (cSCC) is common, but lymph node metastases are rare.
• Lymph node dissection (LND) is the standard treatment for cSCC with lymph node metastases.
• Limited data exists on the clinical course and prognosis following LND for cSCC across all anatomical locations.

Purpose of the Study:

• To describe the clinical course and prognosis of patients undergoing LND for cSCC with lymph node metastases.
• To identify prognostic factors influencing recurrence and survival after LND for cSCC.

Main Methods:

• Retrospective analysis of 268 patients with cSCC and lymph node metastases treated with LND across three centers.
• Uni- and multivariable analyses were performed to identify prognostic factors.

Main Results:

• The 5-year overall survival (OS) and disease-specific survival (DSS) rates were 36% and 52%, respectively.
• 35% of patients experienced recurrence (locoregional and/or distant) after LND.
• Independent predictors for recurrence and worse DSS included primary tumor size >2cm, more than one positive lymph node, and immunosuppression.

Conclusions:

• LND for cSCC with lymph node metastases yields a 5-year DSS of 52%, with approximately one-third experiencing recurrence.
• The study highlights the need for improved systemic treatments for locally advanced cSCC.
• Primary tumor size, lymph node burden, and patient immunosuppression status are critical prognostic indicators.