Summary
Background
A 5-year follow-up study of 633 cutaneous squamous cell cancer (SCC) excisions was
performed by collecting data on rates of local recurrence (LR) and lymph node (LN)
metastasis.
Methods
A retrospective analysis of patients was performed across four regional plastic surgery
centres (Stoke Mandeville Hospital, Aylesbury; John Radcliffe Hospital, Oxford; Salisbury
District Hospital, Salisbury and Queen Alexandra Hospital, Portsmouth) assessing rates
of LR and LN metastasis.
Results
We report 5-year outcomes from 598 SCCs (95% follow-up rate). The total recurrence
rate (LR and LN metastasis) was 6.7% (n = 40) at 5 years, with 96% of these occurring
within 2 years. Median time to LR was 9 months (1–57), with 76.9% (n = 20) undergoing
further wide local excision. Median time to LN metastasis was 5.5 months (1–18 months).
There were two cases of disease-related death. Only 15% (n = 6) of incomplete excisions
recurred. Interestingly, 19.1% (n = 9) of 47 SCCs with perineural invasion on original
histopathology recurred versus only 5.6% (n = 31) of the 551 SCCs without perineural
invasion (p = 0.005).
Conclusions
This study is one of the largest studies to date following up 598 SCC excisions at
5 years with total recurrence rates comparable to those in current published literature.
We report perineural invasion as a significant predictor of recurrence and that 96%
of total recurrence occurred within 2 years. This is in contrast to current UK guidelines
(75% at 2 years, 95% at 5 years), thus suggesting that shorter length of hospital
follow-up may be reasonable.
Keywords
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Article info
Publication history
Published online: May 02, 2018
Accepted:
March 30,
2018
Received in revised form:
February 16,
2018
Received:
November 21,
2016
Footnotes
Authored by a member of BAPRAS
Presented at the Winter Scientific Meeting of the British Association of Plastic & Reconstructive Surgeons (BAPRAS), November 2014, London, UK.
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
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- A review of timelines for metastasis in cutaneous squamous cell carcinoma, and evidence for clinical follow-upJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 72Issue 12
