Risk Factor Number and Recurrence, Metastasis, and Disease-Related Death in Cutaneous Squamous Cell Carcinoma
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View abstract on PubMed
Summary
This summary is machine-generated.The number of risk factors (RFs) in cutaneous squamous cell carcinoma (CSCC) directly correlates with increased risk of recurrence, metastasis, and death. Specifically, CSCCs with three RFs indicate a higher-risk subset within the BWH T2b stage.
Area Of Science
- Oncology
- Dermatology
- Cancer Risk Stratification
Background
- Cutaneous squamous cell carcinoma (CSCC) management relies on risk stratification using tumor staging systems.
- The Brigham and Women's Hospital (BWH) T staging system uses four risk factors (RFs) but lacks precise association between stage and RF number.
- BWH stage T2b encompasses CSCCs with both two and three RFs, necessitating clearer risk differentiation.
Purpose Of The Study
- To investigate the association between the number of risk factors (RFs) and the risk of CSCC recurrence, metastasis, and disease-related death.
- To determine if CSCCs with three RFs represent a distinct higher-risk subset within the BWH T2b stage.
Main Methods
- Retrospective, multinational cohort study including 16,844 invasive CSCCs diagnosed between 1991 and 2023.
- CSCCs were stratified by the number of four specific RFs: tumor diameter (≥2 cm), histology (poorly differentiated), local extension (beyond subcutaneous fat), and nerve invasion (large caliber).
- Analysis focused on five-year cumulative incidences of local recurrence, nodal metastasis, distant metastasis, and disease-specific death.
Main Results
- A significant increase in the risk of local recurrence, nodal metastasis, distant metastasis, and disease-specific death was observed with an increasing number of RFs (0 to 4).
- CSCCs with three RFs showed substantially higher cumulative incidences compared to those with two RFs: local recurrence (1.6-fold), nodal metastasis (1.9-fold), distant metastasis (4.3-fold), and disease-specific death (1.9-fold).
- The risk for all evaluated adverse outcomes increased progressively with each additional RF.
Conclusions
- The number of risk factors (RFs) is a significant independent predictor of adverse outcomes in CSCC.
- CSCCs with three RFs represent a demonstrably higher-risk subset, particularly within the BWH T2b stage, warranting closer monitoring and potentially more aggressive management.
- This finding supports refining CSCC risk stratification beyond current staging systems to better identify high-risk patients.
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