scholarly journals Tumor Characteristics Predicting Perineural Invasion in Cutaneous Squamous Cell Carcinoma Identified by Stepwise Logistic Regression Analysis

2018 ◽  
Author(s):  
Brandon T Beal ◽  
Maulik M Dhandha ◽  
Melinda B Chu ◽  
Vamsi Varra ◽  
Eric S Armbrecht ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Logistic Regression ◽  
High Risk ◽  
Cell Carcinoma ◽  
Perineural Invasion ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Stepwise Logistic Regression ◽  
Factors Associated ◽  
High Risk Factors

Background: Perineural invasion (PNInv) is a significant risk factor for metastasis and death in cutaneous squamous cell carcinoma (cSCC).  Despite this known association, factors contributing to the presence of PNInv are not well characterized.Aims: To determine risk factors associated with the presence of PNInv using the high-risk cSCC criteria developed by the National Comprehensive Cancer Network (NCCN).Methods: After receiving Institutional Review Board approval for this retrospective review, the presence of NCCN high-risk factors for cSCC were recorded for patients treated at a tertiary referral academic medical center, from January 1, 2010 to March 31, 2012. Stepwise logistic regression was used to identify factors associated with the presence of PNInv.Results: PNInv was present in 34 of 507 cSCCs (6.7%). Moderately or poorly differentiated histology (P < .001, OR 6.6 [95% CI, 3.2-13.7]), acantholytic, adenosquamous, or desmoplastic subtype (P =.01, OR 1.8 [95% CI, 0.8-4.2]), and tumors in areas M (≥10mm) and H ( ≥6mm) (P = .05, OR 5.0 [95% CI, 1.2-21.0]) were significantly associated with the presence of PNInv.Conclusions:  This data suggests clinicians should have a higher suspicion and may be able to identify PNInv in high-risk cSCC based on the presence of specific high-risk factors.

Outcomes in MAGE+ cutaneous squamous cell carcinoma with perineural invasion treated with surgery followed by postoperative radiation therapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e21043-e21043
Author(s):  
Mary Stevenson ◽  
Alexis Santana ◽  
Nicole Adell Doudican ◽  
Theresa N Canavan ◽  
Anna C. Pavlick ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Perineural Invasion ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Postoperative Radiation Therapy ◽  
Worst Case ◽  
Potential Biomarker

e21043 Background: Perineural invasion (PNI) is associated with a high risk for recurrence and metastasis from cutaneous squamous cell carcinoma (cSCC). Recommendations vary regarding use of post-operative radiation therapy (PORT). Biomarkers for poor outcome from cSCC with PNI are lacking. We aimed to evaluate outcomes in high-risk cSCC with PNI treated surgically +/- PORT and to evaluate tissue from the primary tumor to identify biomarkers for highest risk. Methods: We conducted a retrospective chart review of PNI SCC patients seen between 2005 and 2014. We compared outcomes for surgery vs. surgery plus PORT. Gene expression from tumor debulk was evaluated via Nanostring. MAGEA3 function was evaluated using PAM 212 SCC cells in a BALB/c mouse model. CRISPR-Cas9 MAGEA3 PAM 212 knockouts were developed to assess role of MAGEA3 in SCC growth. Results: Thirty-two patients with PNI SCC were identified. All were treated surgically, and 18/32 elected to undergo PORT. Nodal metastases were noted in 5/14 patients who did not undergo PORT, whereas no metastases were noted in any patient who underwent PORT. Thus, surgery plus PORT was associated with better outcome than surgery alone (P < 0.01). Local recurrence was not observed in any patients treated by surgery, including 30 patients treated by Mohs micrographic surgery (MMS). MAGEA3 was highly expressed in PNI SCC. MAGEA3 expression in PAM 212 SCC was associated with tumor growth and increased expression of cyclins A, B, and E. CRISPR-Cas9 MAGEA3 PAM 212 knockouts exhibited reduced growth in BALB/c mice. Conclusions: MAGEA3 expression is increased in human PNI SCC. We can mitigate against worst case outcome with surgery plus PORT. MAGEA3 merits further investigation as a potential biomarker for best candidates for surgery plus PORT.

scholarly journals Use of Adjuvant Radiotherapy in the Treatment of High-risk Cutaneous Squamous Cell Carcinoma With Perineural Invasion

2020 ◽  
Vol 156 (8) ◽  
pp. 918
Author(s):  
Mary L. Stevenson ◽  
Maressa C. Criscito ◽  
Reason Wilken ◽  
Nicole A. Doudican ◽  
Earl Eugene Bain ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adjuvant Radiotherapy ◽  
Perineural Invasion ◽  
Cutaneous Squamous Cell Carcinoma

scholarly journals High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck

2007 ◽  
Vol 2007 ◽  
pp. 1-6 ◽  
Author(s):  
Michael J. Veness
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Perineural Invasion ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Depth Of Invasion ◽  
Skin Cancers ◽  
Nonmelanoma Skin Cancers

Nonmelanoma skin cancers (squamous cell and basal cell carcinomas) occur at an epidemic rate in many countries with the worldwide incidence increasing. The sun-exposed head and neck are the most frequent sites for these cancers to arise and in most patients diagnosed with a cutaneous squamous cell carcinoma, local treatment is usually curative. However, a subset is diagnosed with a high-risk cutaneous squamous cell carcinoma. High-risk factors include size (> 2 cm), thickness/depth of invasion (> 4 mm), recurrent lesions, the presence of perineural invasion, location near the parotid gland, and immunosuppression. These patients have a higher risk (> 10–20%) of developing metastases to regional lymph nodes (often parotid nodes), and in some cases also of experiencing local morbidity (perineural invasion), based on unfavourable primary lesion and patient factors. Despite treatment, many patients developing metastatic cutaneous squamous cell carcinoma experience mortality and morbidity usually as a consequence of uncontrolled metastatic nodal disease. It is therefore important that clinicians treating nonmelanoma skin cancers have an understanding and awareness of these high-risk patients. The aim of this article is to discuss the factors that define a high-risk patient and to present some of the issues pertinent to their management.

Sign in / Sign up

Export Citation Format

Share Document