Squamous Cell Carcinoma in a Plastic Surgery Unit at a Hospital: Recurrence and Metastasis

Squamous cell carcinoma (SCC) is the second most prevalent cancer in the world with a worldwide increase of 310% from 1997 to 2017. The prognosis is usually good; however, metastases occur in up to 5% and are linked to high mortality rates. Even though the risk of metastasis and death is low, the mortality now exceeds that of melanoma.

We wanted to investigate the latest tendencies of SCC regarding recurrence and metastasis.

The study was a retrospective, single-centre, cohort study of patients in Central Denmark Region. The purpose was to evaluate all patients receiving surgery for SCC in 2018 and 2019. We evaluated all patients receiving the diagnostic code 'skin cancer' DC44XX.

The cohort consisted of 781 patients with SCC. Of the 781 patients, 63 (8%) were recurrent tumours. Recurrent tumours were more likely to metastasise later. Of the 63 patients that had a recurrent tumour, 19 (30.2%) patients were primarily treated with curettage or cryotherapy. The remaining recurrent tumours were treated with surgical excision. Of these, 7 (11.1%) were treated with undisclosed margins and 8 (12.7%) with positive margins. Late locoregional metastases were present in 12 (1.6%) patients and six (0.8%) patients had locoregional metastases at the time of diagnosis.

Our investigation showed the importance of wide negative excision margins when treating SCC. The higher prevalence of late locoregional metastases than locoregional metastases at diagnosis may suggest lymph node examination in routine controls after excision of SCC and better patient instructions regarding self-examination.