Cutaneous squamous cell carcinoma metastatic to the axilla and groin: Outcomes and prognostic factors

Bucknell, NW; Gyorki, DE; Bressel, M; Estall, V; Webb, A; Henderson, M; Chua, MST; Rischin, D; Tiong, A

Author(s): Bucknell, NW; Gyorki, DE; Bressel, M; Estall, V; Webb, A; Henderson, M; Chua, MST; Rischin, D; Tiong, A;
Details: Publication Year 2022-02,Volume 63,Issue #1,Page 43-52
Journal Title: Australasian Journal of Dermatology
Publication Type: Research article
Abstract: PURPOSE: This study examined the clinical outcomes and prognostic factors of patients with metastatic cutaneous SCC metastatic to the axilla and groin when managed with curative-intent lymphadenectomy and received (neo)adjuvant treatment. METHODS AND MATERIALS: We conducted a single institution retrospective review. Patients who had nodal disease without distant spread were 18 years or older with no non-cutaneous primary identified. RESULTS: From January 2000 to July 2015, 78 patients were treated for axilla (64, 82%) or inguinal (14, 18%) involvement with cSCC. The median age was 75.5 years (range: 29-95), and 8 patients (11%) were immunosuppressed. The median size of the largest node was 45 mm (range: 8-135), and extracapsular extension was found in 63 (81%) cases. A majority of patients were treated with surgery alone (21, 26.9%) and surgery with adjuvant radiation therapy (54, 69%). The 2-year OS and PFS were 50% (95% CI: 40%-63%) and 43% (95% CI: 33%-56%), and 5-year OS and PFS were 33% (95% CI:23%-47%) and 32% (95% CI:22%-46%) respectively in the entire cohort. On univariable analysis, factors associated with longer OS were as follows: younger age (HR 1.1, 95% CI: 0.9-1.3 P = 0.021), improved performance status (HR 1.5, 95% CI:1.0-2.3 P = 0.026), lack of immunosuppression (HR 3.3, 95% CI: 1.5-7.3 P = 0.001), lower lymph node ratio (HR 1.2, 95% CI:1.0-1.3 P = 0.007), lower number of positive nodes (HR 1.1, 95% CI:1.0-1.2 P = 0.004) and the use of radiation therapy (HR 0.5, 95% CI:0.3-0.9 P = 0.012). CONCLUSION: Metastasis to the axilla and groin with cSCC has poor outcomes with standard treatment. The addition of immunotherapy warrants investigation.
Keywords: Adult; Age Factors; Aged; Aged, 80 and over; Axilla/pathology/surgery; Carcinoma, Squamous Cell/mortality/pathology/*secondary/therapy; Female; Groin/pathology/surgery; Humans; Immunocompromised Host; Lymph Node Excision; *Lymphatic Metastasis; Male; Middle Aged; Progression-Free Survival; Radiotherapy, Adjuvant; Retrospective Studies; Skin Neoplasms/mortality/*pathology/therapy; Cutaneous squamous cell carcinoma; nodal metastasis; prognostic factors
Department(s): Radiation Oncology; Surgical Oncology; Biostatistics and Clinical Trials; Medical Oncology
PubMed ID: 34751431
Publisher's Version: https://doi.org/10.1111/ajd.13739
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-11 04:24:45

Last Modified: 2024-10-11 04:26:13