Summary
There is an urgent need for evidence-based management of cutaneous squamous cell carcinoma
(cSCC), particularly “high-risk” tumours.
We performed an online survey of skin cancer specialists to assess cSCC research priorities.
Respondents were targeted via the international Skin Cancer OUTcomes consortium (SCOUT)
and the UK regional Skin Cancer Outcomes North-East (SCONE) research interest group.
Thirty-three respondents completed the survey ([46%; 16/33] were non-UK based). ‘Defining
a role for sentinel lymph node biopsy (SLNB) in high-risk cSCC’ was most commonly
ranked either 1st or 2nd research priority by respondents (55%; 18/33), with near-total
consensus that SLNB could be useful for the early identification of nodal metastasis
in high-risk cSCC (97%; 30/31).
On this specific research priority, 24 studies with longitudinal follow-up data were
identified. Cumulatively, SLNB for cSCC had positivity and false omission rates of
7.0% and 3.1%, respectively, with false negative rates of 29.0%. Given the lack of
consensus on a definition of “high-risk” cSCC, it was unsurprising that only two studies
of SLNB for head & neck cSCC utilised comparable selection criteria; reporting the
highest positivity rates (8.0%) and lowest false-omission rates (2.4%) and false-negative
rates (21.4%) overall.
There is multi-disciplinary interest in the role of SLNB for “high-risk” cSCC. It
appears to perform best in head and neck cases. A consensus definition of “high-risk”
cSCC is urgently required to refine the utility of SLNB and guide risk-directed management.
Keywords
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References
- British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020*.Br J Dermatol. 2021; 184: 401-414
- A study of the effects of delayed patient presentation on cutaneous SCC progression.J Plast, Reconstruct Aesthet Surg. 2022; 75: 722-729
- Systematic review of the prevalence of nodal metastases and the prognostic utility of sentinel lymph node biopsy in cutaneous squamous cell carcinoma.J Dermatol. 2018; 45: 781-790
- Validation of four cutaneous squamous cell carcinoma staging systems using nationwide data*.Br J Dermatol. 2022; 186: 835-842
- Validation of a 40-gene expression profile test to predict metastatic risk in localized high-risk cutaneous squamous cell carcinoma.J Am Acad Dermatol. 2021; 84: 361-369
Article info
Publication history
Published online: November 23, 2022
Accepted:
November 17,
2022
Received:
November 8,
2022
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
