Summary
Introduction
We have previously shown 28.6% of re-excisions for margin-positive cutaneous SCC to
yield residual tumour (positive re-excision). Original tumour diameter and thickness
conferred significant risks for positive re-excision. We now report a 5-year prospective
follow-up of our re-excision cohort.
Results
Of 676 consecutive SCC patients, 84 underwent wider-excision for positive margins.
79 of these patients completed a mean of 28 months follow-up. Overall, 9/79 (11%)
of this re-excision cohort experienced locoregional recurrence, all within 2 years
of primary resection. Of the positive re-excisions, 29% experienced recurrence, vs
5% in those with negative re-excisions. Logistic-regression analysis revealed positive
re-excision to predict recurrence (P < 0.05, RR 10.1), independent from tumour-grade, anatomical site, size, and delay
to re-excision.
Conclusion
Factors associated with residual tumour on re-excision are similar to characteristics
of high-risk SCCs; larger tumours in particular are more likely to persist and may
benefit from wider excision-margins at original resection. Positive re-excision is
newly identified as a significant risk for locoregional recurrence, whilst negative
re-excision is associated with a return to a low-risk prognosis, for all tumours.
Our findings thus support the treatment of cutaneous SCC through to completion. We
also recommend re-excision where narrow or close margins are reported. Patients with
a positive re-excision should be considered at high risk for recurrence, requiring
extended follow-up.
Keywords
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Article info
Publication history
Published online: June 04, 2012
Accepted:
April 26,
2012
Received:
September 25,
2011
Identification
Copyright
© 2012 Published by Elsevier Inc.
