Clinicopathological characteristics and clinical morbidity in high-risk head and neck cutaneous squamous cell carcinoma patients in Western Australia

Grover, P; Flukes, S; Jacques, A; Leedman, S; Lindsay, A; White, R; Friedland, P; Gurfinkel, R; Lim, AM

Author(s): Grover, P; Flukes, S; Jacques, A; Leedman, S; Lindsay, A; White, R; Friedland, P; Gurfinkel, R; Lim, AM;
Details: Publication Year 2022-06,Volume 52,Issue #6,Page 944-951
Journal Title: Internal Medicine Journal
Publication Type: Research article
Abstract: BACKGROUND: There is no registry data on morbidity and mortality of high-risk cutaneous squamous cell carcinoma (cSCC) in Australia. AIM: To examine the clinicopathological features, mortality and morbidity in high-risk cSCC patients in Western Australia (WA). METHODS: A retrospective cohort study was conducted through hospital record review on cSCC patients discussed at multidisciplinary meetings at the two largest WA hospitals between March 2015 and December 2016. RESULTS: Of 141 patients, 129 were evaluable, with median follow up of 43.9 (range 3.0-53.2) months. Patients were predominantly older males (84%) with significant comorbidities (Charlson Comorbidity Index (CCI) >/=5; 76%) and history of previous nonmelanoma skin cancer (57%) with advanced disease (57% stage IV without distant metastasis; American Joint Committee on Cancer, 7th edition). Pathological high-risk features were common including nodal extracapsular extension (47%) and cranial nerve involvement (16%). Clinical morbidity was significant with a median of 2 (range 0-13) excisions and 2 (range 0-21) cSCC-related hospitalisations for any cSCC event following the index case discussion. Recurrences of the primary index lesion occurred in 60% of patients and 20% had >/=2 recurrences. Median overall survival for patients with nonmetastatic disease was 39.8 (range 25.9-53.7) months and 16.1 (range 0.2-32.0) months for metastatic disease. CCI >/=5, advanced nodal stage and >/=2 recurrences were significantly associated with mortality on multivariable analyses (P < 0.05). Nodal extracapsular extension and any recurrences were identified as significant risk factors for disease-specific mortality on multivariable analyses (P < 0.05). CONCLUSION: High-risk cSCC patients have significant health needs represented by high-baseline comorbidities, multiplicity of cSCC events and the number of healthcare-associated interventions. There is an unmet need for robust cancer data collection.
Keywords: *Carcinoma, Squamous Cell/epidemiology/therapy; Extranodal Extension; *Head and Neck Neoplasms/diagnosis/epidemiology/therapy; Humans; Lymphatic Metastasis; Male; Morbidity; Neoplasm Staging; Recurrence; Retrospective Studies; *Skin Neoplasms/epidemiology/therapy; Western Australia/epidemiology; Australia; cutaneous squamous cell carcinoma; high risk; outcome
Department(s): Medical Oncology
PubMed ID: 34800329
Publisher's Version: https://doi.org/10.1111/imj.15630
Open Access at Publisher's Site: https://doi.org/10.1111/imj.15630
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-11-01 12:10:44

Last Modified: 2024-11-01 12:11:37