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Dettrick A, Foden N, Hogan D, Azer M, Blazak J, Atwell D, Buddle N, Min M, Livingston R, Banney L, Donkin R. The hidden Australian skin cancer epidemic, high-risk cutaneous squamous cell carcinoma: a narrative review. Pathology 2024; 56:619-632. [PMID: 38871593 DOI: 10.1016/j.pathol.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 06/15/2024]
Abstract
Deaths from non-melanoma skin cancers (NMSCs) have almost doubled in Australia in recent years. Cutaneous squamous cell carcinoma (cSCC) constitutes approximately 20% of NMSCs, but is responsible for most of the deaths. Most skin cancers are easy to diagnose and treat and therefore cSCC are often trivialised; however, there is a high-risk subgroup of cSCC (HRcSCC) that is associated with a high risk of metastasis and death. The definition of early HRcSCC and our ability to identify them is evolving. Many significant prognostic factors have been identified, but a universally accepted prognostic index does not exist. Guidelines for workup, treatment, and follow-up leave many important decisions open to broad interpretation by the treating physician or multidisciplinary team. Some of the treatments used for metastatic cSCC are not supported by robust evidence and the prognosis of metastatic cSCC is guarded. In this review, we highlight the rapid rise in NMSC deaths and discuss some of the deficiencies in our knowledge of how to define, diagnose, stage, and manage HRcSCC.
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Affiliation(s)
- Andrew Dettrick
- Anatomical Pathology, Pathology Queensland, Sunshine Coast, Qld, Australia; School of Health, University of the Sunshine Coast, Qld, Australia.
| | - Neil Foden
- Ear, Nose and Throat, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - David Hogan
- Ear, Nose and Throat, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Mary Azer
- Medical Oncology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - John Blazak
- Radiology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Daisy Atwell
- Radiation Oncology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Nicole Buddle
- Radiation Oncology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Myo Min
- School of Health, University of the Sunshine Coast, Qld, Australia; Radiation Oncology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia; School of Medicine and Dentistry, Griffith University, Sunshine Coast, Qld, Australia
| | - Ryan Livingston
- Plastic Surgery, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Leith Banney
- Dermatology, Sunshine Coast University Hospital, Sunshine Coast, Qld, Australia
| | - Rebecca Donkin
- School of Health, University of the Sunshine Coast, Qld, Australia; School of Medicine and Dentistry, Griffith University, Sunshine Coast, Qld, Australia
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Yaqoob O, Dalle Carbonare M, Komath D. Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Retrospective Analysis of Loco-Regional Recurrences and Survival Rates Over a Consecutive 10-Year Period. Cureus 2024; 16:e64805. [PMID: 39156395 PMCID: PMC11329946 DOI: 10.7759/cureus.64805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/20/2024] Open
Abstract
INTRODUCTION Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers worldwide. Due to the ever-increasing sun exposure and life expectancy, cSCCs are increasing worldwide. The aim of our study was to identify specific risk factors leading to local and regional recurrences, determine patients' survival rates, and identify best practices for the management of cSCC. METHODOLOGY This study retrospectively analyzed 1197 head and neck cSCCs in 945 patients who consecutively presented to the clinics from January 2007 to December 2016. Patients were followed up for a minimum of 18 months. RESULTS A total of 29 patients (3%) developed loco-regional recurrences (26 local, one regional, and two both local and regional) with a median time to recurrence of 25 (range, 1-81) months. The mean follow-up was 32 (range, 5-90) months. Treatment modality (p=0.027), depth of invasion (p<0.001), diameter > 20 mm (p<0.001), gender (p=0.022), histological differentiation (p<0.001), site of the lesion (p<0.001), perineural and intravascular invasion (p<0.001), positive lymphadenopathy (p=0.021), immunosuppression (p<0.001), and history of treatment (p=0.008) proved to be strong predictors for loco-regional recurrences. At one and five years after diagnosis, 95.6% and 59.9% of all patients were recurrence-free, respectively. The median survival time from recurrence was 2.6 years. CONCLUSION Our study identifies prognostic indicators for reoccurrence by analyzing data from a large continuous cohort in the management of cSCCs.
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Affiliation(s)
- Omar Yaqoob
- Oral and Maxillofacial Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, GBR
| | - Marco Dalle Carbonare
- Oral and Maxillofacial Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, GBR
| | - Deepak Komath
- Oral and Maxillofacial Surgery, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, GBR
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3
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Chen AM, Harris JP, Tjoa T, Haidar Y, Armstrong WB. Refining Target Volume Coverage After Parotidectomy for Cutaneous Squamous Cell Carcinoma: Omission of the Cervical Neck From the Radiation Field. Adv Radiat Oncol 2024; 9:101306. [PMID: 38260235 PMCID: PMC10801645 DOI: 10.1016/j.adro.2023.101306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/25/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose For patients without pathologic evidence of cervical disease after neck dissection for cutaneous squamous cell carcinoma involving the parotid region, inclusion of the ipsilateral cervical neck in the postparotidectomy radiation volume is routinely performed. We report our experience with selective avoidance of the ipsilateral neck for patients undergoing postoperative radiation to the parotid bed. Methods and Materials From January 2014 to December 2023, a total of 30 consecutive patients underwent postoperative radiation after parotidectomy for cutaneous squamous cell carcinoma involving the parotid area. All patients had previously had a neck dissection confirming pathologic N0 disease. Treatment was delivered using intensity modulated radiation therapy to a median dose of 60 Gy (range, 56-66 Gy). The radiation target volumes included the parotid bed only, with deliberate avoidance of the ipsilateral cervical neck. The median pathologic tumor size of the parotid tumor was 3.3 cm (range, 0.2-9.4 cm). Final pathologic evaluation showed positive microscopic margins in 8 patients (27%), perineural invasion in 17 patients (57%), and facial nerve involvement in 6 patients (20%). Results There were no isolated nodal failures. One patient developed an ipsilateral neck recurrence approximately 8 months after completion of radiation therapy. This occurred 2 months subsequent to the development of local recurrence. The 5-year actuarial rates of local (parotid) control, neck control, and overall survival were 87%, 97%, and 76%, respectively. Conclusions Omission of the ipsilateral neck from the parotid volume does not compromise disease control for pathologically N0 patients undergoing postoperative radiation for cutaneous squamous cell carcinoma involving the parotid region. Practical implications are discussed.
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Affiliation(s)
| | | | - Tjoson Tjoa
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
| | - Yarah Haidar
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
| | - William B. Armstrong
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
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4
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Yosefof E, Kurman N, Yaniv D. The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer. Cancers (Basel) 2023; 15:cancers15092408. [PMID: 37173875 PMCID: PMC10177122 DOI: 10.3390/cancers15092408] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Non-melanoma skin cancer (NMSC) is the most common malignancy in the United States. While surgery is considered as the main treatment modality for both cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC), radiotherapy plays an important role in the treatment of NMSC, both in the adjuvant setting for cases considered high-risk for recurrence, and in the definitive setting, when surgery is not feasible or desired by the patient. The last years have seen the emergence of immunotherapy treatment for cases of advanced cSCC in the palliative, and possibly neoadjuvant settings, making the treatment paradigm more complex. In this review, we attempt to describe the different radiation modalities available for the treatment of NMSC, the indications for adjuvant post-operative treatment with radiotherapy for cSCC, the role of radiotherapy in elective neck treatment, and the efficacy, safety, and toxicity profile of this treatment in these different settings. Furthermore, we aim to describe the efficacy of radiotherapy combined with immunotherapy as a promising horizon for treating advanced cSCC. We also aim to describe the ongoing clinical studies that attempt to examine future directions for the role of radiation treatment in NMSC.
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Affiliation(s)
- Eyal Yosefof
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 4941492, Israel
| | - Noga Kurman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 4941492, Israel
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petah Tikva 4941492, Israel
| | - Dan Yaniv
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX 77054, USA
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5
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Trignano E, Tettamanzi M, Rampazzo S, Trignano C, Boccaletti R, Fadda GM, Sanna F, Bussu F, Cossu A, Rubino C. Squamous cell carcinoma of the scalp: a combination of different therapeutic strategies. Case Reports Plast Surg Hand Surg 2023; 10:2210670. [PMID: 37197191 PMCID: PMC10184606 DOI: 10.1080/23320885.2023.2210670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
A case study of a 71-year-old man with a giant cutaneous squamous cell carcinoma of the scalp and calvaria is presented, where a combination of surgical excision, reconstruction with a latissimus dorsi muscular free flap, immunotherapy, and radiotherapy were used to control the disease for two years without recurrence.
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Affiliation(s)
- Emilio Trignano
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
- CONTACT Emilio Trignano
| | - Matilde Tettamanzi
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Silvia Rampazzo
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
- Silvia Rampazzo Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Forensic Department, Sassari, Italy
| | | | | | - Fabrizio Sanna
- Institute of Radiological Sciences, University of Sassari, Italy
| | - Francesco Bussu
- Department of Surgical, Microsurgical and Medical Sciences, Otolaryngology Unit, University of Sassari, Sassari, Italy
| | - Antonio Cossu
- Department of Medical, Surgical and Experimental Sciences, Pathology Unit, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
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Gevorkov AR, Boyko AV, Polyakov AP, Chernichenko AV, Gerasimov VA, Meshcheryakova IA, Kaprin AD. Radiotherapy for cutaneous squamous cell carcinoma: current standards and outlooks. HEAD AND NECK TUMORS (HNT) 2022. [DOI: 10.17650/2222-1468-2022-12-3-53-70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cutaneous squamous cell carcinoma accounts for 20 % of all malignant non-melanoma skin tumors, which is one of the most common cancers worldwide. Antitumor treatment is usually very effective: cure rate reaches 90 %, while local recurrence rate is 25 %. The main treatment option for primary skin cancers is surgery. The most significant risk factors for locoregional recurrence include tumor location (head and neck), size (>2 cm), depth of invasion (>4 mm), tumor differentiation grade, perineural invasion, immune system disorders (immunosuppression), severe concomitant diseases, and previous treatment.In patients with advanced cutaneous squamous cell carcinoma, 1-year, 2-year, and 3-year survival rates are 50–80, 30–35 and 15–16 %, respectively. Radiotherapy is a radical treatment option that increases the 5-year survival rate to 90 % and ensures good cosmetic results in 80 % of cases. There are 3 main variants of radiotherapy for cutaneous squamous cell carcinoma: sole radiotherapy according to a radical program, adjuvant radiotherapy in combination with surgery, and palliative radiotherapy. most frequently, radiotherapy is used as part of adjuvant postoperative treatment and is not initially considered as a sole conservative treatment for cutaneous squamous cell carcinoma patients below 45 years of age with resectable tumors, especially high-risk tumors. palliative radiotherapy is an affordable and effective method for combating painful symptoms; moreover, it often provides long-term local control.
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Affiliation(s)
- A. R. Gevorkov
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - A. V. Boyko
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - A. P. Polyakov
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - A. V. Chernichenko
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - V. A. Gerasimov
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - I. A. Meshcheryakova
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia
| | - A. D. Kaprin
- P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia; National Medical Research Center of Radiology, Ministry of Health of Russia; Рeoples’ Friendship University of Russia
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7
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Systematic review on outcomes of the use of adjuvant pharmacotherapy for treatment of cutaneous malignancies exhibiting perineural invasion: promising efficacy of anti-PD1 therapy. Arch Dermatol Res 2022; 315:1075-1082. [DOI: 10.1007/s00403-022-02482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/15/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022]
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8
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Guzman AK, Schmults CD, Ruiz ES. Squamous Cell Carcinoma. Dermatol Clin 2022; 41:1-11. [DOI: 10.1016/j.det.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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9
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Ferini G, Palmisciano P, Forte S, Viola A, Martorana E, Parisi S, Valenti V, Fichera C, Umana GE, Pergolizzi S. Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: The Current and Future Role of Radiation Therapy in the Era of Immunotherapy. Cancers (Basel) 2022; 14:1871. [PMID: 35454779 PMCID: PMC9032290 DOI: 10.3390/cancers14081871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023] Open
Abstract
Radiation therapy (RT) is an effective therapeutic option for small localized cutaneous squamous cell carcinoma (cSCC) among patients who are not eligible for or refuse surgery. RT also has a defined role as an adjuvant treatment in cases of adverse features that predispose to tumor recurrence after local excision. Since the development of cSCC is often a late consequence of chronic sun exposure, its occurrence is more common among elderly patients whose comorbidities may contraindicate surgical procedures. These could be impeded not only by frail medical conditions but also by technical issues. Indeed, an aggressive locoregional behavior of cSCC may culminate in unresectability due to widespread invasion of neighboring tissues. Moreover, cSCC could develop distant metastases. Both locally advanced and metastatic cSCCs carry a poor prognosis. In these scenarios, recent discoveries of tumor molecular targets are promoting the use of promising systemic therapies, especially immunotherapy, over RT. However, the results from using immunotherapy and, even more so, of chemotherapy are still not optimal. By contrast, advances in radiation delivery equipment can safely treat even large and complex-shaped cSCC targets in challenging body sites. In addition, RT could also have a role in metastatic cSCC settings by enhancing the effectiveness of concomitant immunotherapy. The aim of this review is to summarize and comment on the body of literature about the use of radiotherapy for operable and inoperable locally advanced cSCCs and for metastatic ones in an attempt to define its current and future role.
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Affiliation(s)
- Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia srl, Via Penninazzo 11, 95029 Viagrande, Italy;
| | | | - Stefano Forte
- IOM Ricerca srl, Via Penninazzo 11, 95029 Viagrande, Italy; (S.F.); (E.M.)
| | - Anna Viola
- Fondazione Istituto Oncologico del Mediterraneo, 95029 Viagrande, Italy;
| | - Emanuele Martorana
- IOM Ricerca srl, Via Penninazzo 11, 95029 Viagrande, Italy; (S.F.); (E.M.)
| | - Silvana Parisi
- Radiation Oncology Unit—Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (S.P.); (S.P.)
| | - Vito Valenti
- Department of Radiation Oncology, REM Radioterapia srl, Via Penninazzo 11, 95029 Viagrande, Italy;
| | - Corrado Fichera
- Department of Plastic Surgery, Istituto Oncologico del Mediterraneo, 95029 Viagrande, Italy;
| | - Giuseppe Emmanuele Umana
- Trauma and Gamma-Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Stefano Pergolizzi
- Radiation Oncology Unit—Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (S.P.); (S.P.)
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10
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Kejner AE, Harris BN, Patel R, McMullen C, Weir J, Dahshan BA, Carroll WR, Gillespie MB. Management of the parotid for high-risk cutaneous squamous cell carcinoma: A review from the salivary section of the American Head and Neck Society. Am J Otolaryngol 2022; 43:103374. [PMID: 35158264 DOI: 10.1016/j.amjoto.2022.103374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/22/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Metastases to the parotid nodal basin in patients with high-risk cutaneous squamous cell carcinoma (HRcSCC) impact disease specific survival (DSS) and overall survival (OS). METHODS A writing group convened by the Salivary Section of the American Head and Neck Society (AHNS) developed contemporary, evidence-based recommendations regarding management of the parotid nodal basin in HRcSCC based on available literature, expert consultation, and collective experience. The statements and recommendations were then submitted and approved by the AHNS Salivary Committee. RESULTS These recommendations were developed given the wide variation of practitioners who treat HRcSCC in order to streamline management of the parotid nodal basin including indications for imaging, surgery, radiation, and systemic treatment options as well. CONCLUSIONS This clinical update represents contemporary optimal management of the parotid nodal basin in HRcSCC and is endorsed by the Salivary Section of the AHNS.
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11
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Maeda T, Yoshino K. Management of elderly patients with advanced cutaneous squamous cell carcinoma. Jpn J Clin Oncol 2022; 52:214-220. [PMID: 35088087 DOI: 10.1093/jjco/hyab213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/29/2021] [Indexed: 11/12/2022] Open
Abstract
The incidence of cutaneous squamous cell carcinoma has been increasing rapidly in recent years, especially among the elderly. The purpose of this review article is to summarize the findings of studies on systemic therapy for advanced cutaneous squamous cell carcinoma, to review geriatric screening tools, which can assess frailty and predict treatment outcomes, and discuss the indications of their use in advanced cases. A literature review revealed that studies on systemic therapy for advanced cutaneous squamous cell carcinoma often included relatively older patients. However, there has been little research on the safety and efficacy of systemic therapy for advanced disease that takes older age and frailty into account. Notably, studies on geriatric screening for skin cancer have been conducted in recent years, mainly to detect early-stage resectable cases. The Geriatric 8 screening tool is considered the most useful for predicting post-operative complications in patients with early-stage cancer, as it can evaluate comorbidities, polypharmacy and cognition, has appropriate measurement properties, can be quickly executed and is clinically relevant, easily understandable and interpretable. This geriatric screening tool may also be applicable in advanced-stage cancer. In conclusion, despite the fact that advanced cutaneous squamous cell carcinoma occurs mainly in the elderly, the importance of geriatric screening has not yet been fully appreciated by dermato-oncologists. In the future, geriatric screening tools should be actively used in clinical trials for the appropriate assessment of drug efficacy and toxicity in elderly patients with advanced cutaneous squamous cell carcinoma.
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Affiliation(s)
- Takuya Maeda
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Koji Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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12
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Schmults CD, Blitzblau R, Aasi SZ, Alam M, Andersen JS, Baumann BC, Bordeaux J, Chen PL, Chin R, Contreras CM, DiMaio D, Donigan JM, Farma JM, Ghosh K, Grekin RC, Harms K, Ho AL, Holder A, Lukens JN, Medina T, Nehal KS, Nghiem P, Park S, Patel T, Puzanov I, Scott J, Sekulic A, Shaha AR, Srivastava D, Stebbins W, Thomas V, Xu YG, McCullough B, Dwyer MA, Nguyen MQ. NCCN Guidelines® Insights: Squamous Cell Skin Cancer, Version 1.2022. J Natl Compr Canc Netw 2021; 19:1382-1394. [PMID: 34902824 DOI: 10.6004/jnccn.2021.0059] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The NCCN Guidelines for Squamous Cell Skin Cancer provide recommendations for diagnostic workup, clinical stage, and treatment options for patients with cutaneous squamous cell carcinoma. The NCCN panel meets annually to discuss updates to the guidelines based on comments from panel members and the Institutional Review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new surgical recommendation terminology (peripheral and deep en face margin assessment), as well as recent updates on topical prophylaxis, immunotherapy for regional and metastatic disease, and radiation therapy.
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Affiliation(s)
| | | | | | - Murad Alam
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | - Brian C Baumann
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Jeremy Bordeaux
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | - Carlo M Contreras
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | - Roy C Grekin
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | - Alan L Ho
- Memorial Sloan Kettering Cancer Center
| | | | | | | | | | - Paul Nghiem
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Soo Park
- UC San Diego Moores Cancer Center
| | - Tejesh Patel
- St. Jude Children's Research Hospital/University of Tennessee Health Science Center
| | | | - Jeffrey Scott
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | - Yaohui G Xu
- University of Wisconsin Carbone Cancer Center; and
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13
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Rabinowits G, Migden MR, Schlesinger TE, Ferris RL, Freeman M, Guild V, Koyfman S, Pavlick AC, Swanson N, Wolf GT, Dinehart SM. Evidence-Based Consensus Recommendations for the Evolving Treatment of Patients with High-Risk and Advanced Cutaneous Squamous Cell Carcinoma. JID INNOVATIONS 2021; 1:100045. [PMID: 34909742 PMCID: PMC8659794 DOI: 10.1016/j.xjidi.2021.100045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 01/11/2023] Open
Abstract
Cutaneous squamous cell carcinoma is the second most common skin cancer in the United States. Currently, there is no standardized management approach for patients with cutaneous squamous cell carcinoma who develop metastatic or locally advanced disease and are not candidates for curative surgery or curative radiation. To address this issue, the Expert Cutaneous Squamous Cell Carcinoma Leadership program convened an expert steering committee to develop evidence-based consensus recommendations on the basis of a large, structured literature review. Consensus was achieved through modified Delphi methodology. The steering committee included five dermatologists, three medical oncologists, two head and neck surgeons, one radiation oncologist, and a patient advocacy group representative. The steering committee aligned on the following clinical topics: diagnosis and identification of patients considered not candidates for surgery; staging systems and risk stratification in cutaneous squamous cell carcinoma; the role of radiation therapy, surgery, and systemic therapy in the management of advanced disease, with a focus on immunotherapy; referral patterns; survivorship care; and inclusion of the patient's perspective. Consensus was achieved on 34 recommendations addressing 12 key clinical questions. The Expert Cutaneous Squamous Cell Carcinoma Leadership steering committee's evidence-based consensus recommendations may provide healthcare professionals with practically oriented guidance to help optimize outcomes for patients with advanced cutaneous squamous cell carcinoma.
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Affiliation(s)
- Guilherme Rabinowits
- Division of Hematology Oncology, Miami Cancer Institute/Baptist Health South Florida, Miami, Florida, USA
| | - Michael R. Migden
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Robert L. Ferris
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of of Radiation Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Morganna Freeman
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | | | - Shlomo Koyfman
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anna C. Pavlick
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York City, New York, USA
| | - Neil Swanson
- Oregon Health & Science University, Portland, Oregon, USA
| | - Gregory T. Wolf
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Scott M. Dinehart
- Arkansas Dermatology & Skin Cancer Center, Little Rock, Arkansas, USA
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14
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Gilbar PJ, Pokharel K. Severe cisplatin-induced renal toxicity in a patient with xeroderma pigmentosum. J Oncol Pharm Pract 2021; 28:466-470. [PMID: 34647821 DOI: 10.1177/10781552211038246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Xeroderma pigmentosum is a rare genetic disorder of DNA repair, defined by extreme sensitivity to sunlight, leading to sunburn, skin pigmentation and increased incidence of skin cancers. Cisplatin acts by interfering with DNA repair mechanisms to cause DNA damage and apoptosis. It has indications in many malignancies including bladder, head and neck and lung cancers. Acute kidney injury is a well-known complication of cisplatin. CASE REPORT We report a 42-year-old male with a long history of Xeroderma pigmentosum treated with adjuvant cisplatin (40 mg/m2) in combination with radiotherapy for cutaneous squamous cell carcinoma of the neck. He presented to clinic prior to his second weekly dose of cisplatin with a severe acute kidney injury and a creatine level of 813 mmol/L and eGFR of 7 mL/min. No myelosuppression was present. MANAGEMENT AND OUTCOME Treatment consisted of aggressive electrolyte and fluid management. Creatinine levels slowly improved with conservative management without the need for dialysis. Radiation was completed without further cisplatin. DISCUSSION Three cases of severe adverse effects from cisplatin administration in patients with Xeroderma pigmentosum have been reported, with all fatal. Xeroderma pigmentosum complementation group C plays an important role in the DNA repair process with the recognition and repair of damage to normal cells following cisplatin. Patients with Xeroderma pigmentosum can be carriers of defective Xeroderma pigmentosum complementation group C and if the degree of Xeroderma pigmentosum complementation group C inactivity is significant, fatalities could occur. Physicians should be aware of this rare but potentially lethal toxicity when considering systemic therapy for squamous cell carcinoma in patients diagnosed with Xeroderma pigmentosum.
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Affiliation(s)
- Peter J Gilbar
- Cancer Care Services, Toowoomba Hospital, Australia.,Rural Clinical School, Faculty of Medicine, The University of Queensland, Australia
| | - Khageshwor Pokharel
- Cancer Care Services, Toowoomba Hospital, Australia.,Rural Clinical School, Faculty of Medicine, The University of Queensland, Australia
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15
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Mousa AK, Elshenawy AA, Maklad SM, Bebars SMM, Burezq HA, Sayed SE. Post-burn scar malignancy: 5-year management review and experience. Int Wound J 2021; 19:895-909. [PMID: 34535972 PMCID: PMC9013596 DOI: 10.1111/iwj.13690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022] Open
Abstract
The study spotlights a severe uncommon post‐burn complication, Marjolin's ulcer, in upper Egypt plastic and wound care centres. This problem is mainly related to inadequate medical care and awareness. No community or race is immune. The underlying malignant transformation mechanism remains unclear. The study aims, according to our experience, to review the prognostic factors through the management protocol of Marjolin's ulcers. This prospective study was conducted in the Aswan University Plastic & Burn surgery department in South Egypt between 2013 and 2020 and investigated 226 patients with chronic post‐burn ulceration. Nineteen cases were proved to have Marjolin's ulcer, and the other cases that had been excluded from being malignant went for reconstruction with split‐thickness skin graft with/without flap after adequate ulcer debridement. The surgical, oncologic, radiologic indications, and prognostic factors were reviewed according to our management outcome—the assessment with follow‐up period extended over 5 years. Histopathology of ulcers ranged among mild, moderate, and poorly differentiated squamous cell carcinoma. One scalp ulcer case showed basosquamous pathology. Most cases presented at age above 50, but no age was immune. The mean latent period was 29 years on average. The lesions' sites varied in their anatomic location where they involved the upper extremity, the scalp, and the lower extremity that had a predilection. Although surgical excision is the primary management line for tumour ablation, other factors may change the management course. During the follow‐up period, neoplasm recurrence in the form of lymph node enlargement and/or locoregional metastasis was detected in eight cases. Within 1 year after the intervention, six recurrent cases died, and two were saved. In addition to the case study, this paper reviewed the literature and provided our team a good experience in light of the NCCN protocol for non‐melanotic cutaneous carcinoma, although we suffered limited medical resources. It is concluded that early accurate diagnosis, low‐grade malignancy, and well‐planned individualised surgery with adjuvant radiotherapy were the best prognostic factors. The close follow‐up for an early sign of disease recurrence is paramount.
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Affiliation(s)
- Ahmed K Mousa
- Plastic & Reconstructive Surgery - Medical School of Aswan University, Aswan, Egypt
| | | | - Salah M Maklad
- Radiology Department, Medical School of Aswan University, Aswan, Egypt
| | - Shaimaa M M Bebars
- Department of Clinical Pathology, Medical School of Aswan University, Aswan, Egypt
| | - Hisham A Burezq
- Consultant Plastic & Reconstruction - Ibn Sina Hospitals - AlBabtain Center for Burn & Plastic Surgery, Kuwait City, Kuwait
| | - Sherif E Sayed
- Surgical Oncology, Medical School of Bany-Swif University, Bany-Swif, Egypt
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16
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Newman JG, Hall MA, Kurley SJ, Cook RW, Farberg AS, Geiger JL, Koyfman SA. Adjuvant therapy for high-risk cutaneous squamous cell carcinoma: 10-year review. Head Neck 2021; 43:2822-2843. [PMID: 34096664 PMCID: PMC8453797 DOI: 10.1002/hed.26767] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Standard of care for high-risk cutaneous squamous cell carcinoma (cSCC) is surgical excision of the primary lesion with clear margins when possible, and additional resection of positive margins when feasible. Even with negative margins, certain high-risk factors warrant consideration of adjuvant therapy. However, which patients might benefit from adjuvant therapy is unclear, and supporting evidence is conflicting and limited to mostly small retrospective cohorts. Here, we review literature from the last decade regarding adjuvant radiation therapy and systemic therapy in high-risk cSCC, including recent and current trials and the role of immune checkpoint inhibitors. We demonstrate evidence gaps in adjuvant therapy for high-risk cSCC and the need for prognostic tools, such as gene expression profiling, to guide patient selection. More large-cohort clinical studies are needed for collecting high-quality, evidence-based data for determining which patients with high-risk cSCC may benefit from adjuvant therapy and which therapy is most appropriate for patient management.
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Affiliation(s)
- Jason G. Newman
- Department of Otorhinolaryngology – Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Mary A. Hall
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Sarah J. Kurley
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Robert W. Cook
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Aaron S. Farberg
- Section of DermatologyBaylor University Medical CenterDallasTexasUSA
| | - Jessica L. Geiger
- Department of Hematology and Medical OncologyCleveland ClinicClevelandOhioUSA
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17
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Kreinbrink PJ, Mierzwa ML, Huth B, Redmond KP, Wise-Draper TM, Casper K, Li J, Takiar V. Adjuvant radiation and cetuximab improves local control in head and neck cutaneous squamous cell carcinoma: A phase II study. Head Neck 2021; 43:3408-3416. [PMID: 34363266 DOI: 10.1002/hed.26835] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/26/2021] [Accepted: 07/29/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cutaneous squamous cell carcinoma of the head/neck (CSCCHN) is common due to chronic sun exposure. As CSCCHN highly expresses EGFR, we prospectively studied postoperative concurrent cetuximab with radiotherapy for locally advanced CSCCHN (LA-CSCCHN). MATERIALS AND METHODS Single-institutional phase II trial of LA-CSCCHN (NCT XXXX). Adjuvant radiation was given with concurrent cetuximab. Primary endpoint of 2-year LRC and secondary objectives of 2-year disease-free survival (DFS) and 2-year OS were assessed by Kaplan-Meier analysis. RESULTS Twenty-four patients ages 47-88 (median 71 years) were treated from 2014 to 2017. Fourteen patients had T3/4 disease, 5 had N1 disease, and 7 were N2/3. At median follow-up of 42 months, median OS and DFS was not reached and 64 months. Two-year OS was 75%, 2-year DFS was 70.8%. LRC was 91.1% at 2 years. All grade 3 adverse events were related to skin toxicity (12.5% radiation-related dermatitis, 16.7% cetuximab-related rash). CONCLUSIONS LRC compares favorably to historical data examining postoperative radiation alone but requires further investigation.
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Affiliation(s)
- Paul J Kreinbrink
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michelle L Mierzwa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Brad Huth
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kevin P Redmond
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Trisha M Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Keith Casper
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Junan Li
- The Ohio State University College of Pharmacy, Columbus, Ohio, USA
| | - Vinita Takiar
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, USA.,Cincinnati VA Medical Center, Cincinnati, Ohio, USA
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18
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New Developments in the Management of Cutaneous Squamous Cell Carcinoma. Plast Reconstr Surg 2021; 147:492-504. [PMID: 33620947 DOI: 10.1097/prs.0000000000007678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. List important prognostic features that affect cutaneous squamous cell carcinoma risk. 2. Summarize the changes to the AJCC Cancer Staging Manual, Eighth Edition, staging system for cutaneous squamous cell carcinoma. 3. Evaluate the draining nodal basin with appropriate imaging modalities. 4. Recommend adjuvant radiation therapy in the correct clinical setting for high-risk tumors. 5. Recognize the currently available treatments for advanced cutaneous squamous cell carcinoma. SUMMARY This continuing medical education article reviews the features, management, and prognosis of cutaneous squamous cell carcinoma with an emphasis on high-risk squamous cell carcinoma and data from the past 3 years. This review will discuss the primary tumor management, high-risk features of a squamous cell carcinoma, changes to the American Joint Committee on Cancer staging system, and the utility of sentinel lymph node biopsy, and critically review the evidence regarding adjuvant therapy.
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19
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Ansai SI, Umebayashi Y, Katsumata N, Kato H, Kadono T, Takai T, Namiki T, Nakagawa M, Soejima T, Koga H, Sugaya M. Japanese Dermatological Association Guidelines: Outlines of Guidelines for Cutaneous Squamous Cell Carcinoma 2020. J Dermatol 2021; 48:e288-e311. [PMID: 33963604 DOI: 10.1111/1346-8138.15889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 01/04/2023]
Abstract
In consideration of the development of treatment options for squamous cell carcinoma (SCC), the Japanese Skin Cancer Society issued the first guidelines of SCC in 2007 and revised them in 2015. Here, we report the English version of the 2020 edition of the Japanese SCC guidelines. The first half of this article is an overview of SCC including actinic keratosis and Bowen's disease, and the second half discusses three clinical questions: (i) treatment of actinic keratosis; (ii) determination of the resection margin of the primary lesion; and (iii) treatment of radically incurable cases, as contemporary problems encountered in treating SCC. In these evaluations, all processes were implemented according to the Grading of Recommendations, Assessment, Development, Evaluation system. Also, items of recommendation concerning each clinical question were determined by a multidisciplinary expert panel consisting of dermatologists, plastic/reconstructive surgeons, radiologists, and oncologists through a comprehensive literature search and systematic reviews.
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Affiliation(s)
- Shin-Ichi Ansai
- Division of Dermatology and Dermatopathology, Nippon Medical School Musashi Kosugi-Hospital, Kawasaki, Japan
| | - Yoshihiro Umebayashi
- Department of Dermatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashi Kosugi-Hospital, Kawasaki, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Toshihiro Takai
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Takeshi Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Nakagawa
- Department of Plastic and Reconstructive Surgery, Shizuoka Prefectural Cancer Center, Nagaizumi, Japan
| | | | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Narita, Japan
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20
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McMullen CP, Ow TJ. The Role of Systemic Therapy in Advanced Cutaneous Squamous Cell Carcinoma. Otolaryngol Clin North Am 2021; 54:343-355. [PMID: 33583597 DOI: 10.1016/j.otc.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Systemic therapy for patients with head and neck cutaneous squamous cell carcinoma (HNCSCC) generally is used for patients with advanced disease and most often employed for patients in the palliative setting when disease is unresectable and/or widely metastatic. Cytotoxic agents and epidermal growth factor receptor pathway targeted therapy have been utilized most commonly, with few clinical data to support their efficacy. Adjuvant postoperative chemoradiation with platinum has been called into question based on recent data. Programmed cell death protein 1 receptor immune checkpoint inhibitors have demonstrated profound activity in HNCSCC, and cemiplimab and pembrolizumab now are approved for use for unresectable/metastatic disease.
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Affiliation(s)
- Caitlin P McMullen
- Department of Head and Neck - Endocrine Oncology Program, Moffit Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
| | - Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, 3400 Bainbridge Avenue, 3rd Floor Medical Arts Pavilion, Bronx, NY 10467, USA; Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, 3400 Bainbridge Avenue, 3rd Floor Medical Arts Pavilion, Bronx, NY 10467, USA
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21
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Dong X, Lu N, Tong Z, Shi Y. Successful Use of Nivolumab in a Patient with Head and Neck Cancer After Allogeneic Bone Marrow Transplantation. Onco Targets Ther 2021; 14:929-936. [PMID: 33603397 PMCID: PMC7882438 DOI: 10.2147/ott.s267022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/16/2021] [Indexed: 11/23/2022] Open
Abstract
Recently, programmed cell death 1(PD-1) inhibitors have shown a significant curative effect in the treatment of most solid cancers and some hematological malignancies. The effects of PD-1 inhibitors in recurrent head and neck squamous cell carcinoma (HNSCC) have also been confirmed. However, there is a lack of reliable clinical evidence to confirm the safety and efficacy of PD-1 inhibitors in patients after allogeneic hematopoietic stem cell transplantation, especially when the patient has a second primary cancer. Generally, graft-versus-host disease (GVHD) is unpredictable among these patients. Here we report the case of a patient who successfully used nivolumab without any GVHD or other immune-related adverse events for HNSCC after allogeneic bone marrow transplantation because of the Philadelphia chromosome-positive T cell acute lymphoblastic leukemia.
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Affiliation(s)
- Xiaopei Dong
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, People's Republic of China
| | - Ning Lu
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, People's Republic of China
| | - Zhongsheng Tong
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, People's Republic of China
| | - Yehui Shi
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, People's Republic of China
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22
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Lebas E, Marchal N, Rorive A, Nikkels AF. Cemiplimab for locally advanced cutaneous squamous cell carcinoma: safety, efficacy, and position in therapy panel. Expert Rev Anticancer Ther 2021; 21:355-363. [PMID: 33554680 DOI: 10.1080/14737140.2021.1876567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Locally advanced cutaneous squamous cell carcinoma (lacSCC) is rare. Approximately one-fourth of the cases are observed among immunocompromised patients, in particular in solid organ transplant recipients (OTRs). LacSCC has a very poor prognosis. Surgery with or without radiotherapy remains the golden standard of treatment for cSCC. However, in advanced cases, there is a medical need for alternative treatment options. Classic systemic treatments include chemotherapy and/or EGFR inhibitors. Recently the effectiveness of programmed cell death protein-1 (PD-1) inhibitors has been demonstrated for lacSCC. Cemiplimab is a recombinant IgG4 human monoclonal antibody against the PD-1 protein for the intravenous treatment of lacSCC. AREAS COVERED The principal studies evaluating the efficacy and safety of cemiplimab for lacSCC are presented. EXPERT OPINION Cemiplimab is the first anti-PD-1 antibody that was FDA (2018) and EMA (2019) approved as a systemic treatment for lacSCC and/or metastatic cSCC when curative surgery or radiotherapy is no longer amenable. For this situation, experts currently recommend cemiplimab as a first-line systemic alternative. As cemiplimab therapy is potentially associated with a risk of organ graft rejection, pros and cons should be evaluated for every individual OTR patient with lacSCC.
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Affiliation(s)
- Eve Lebas
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Nathalie Marchal
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Andrée Rorive
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Arjen F Nikkels
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
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23
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Tam S, Gajera M, Luo X, Glisson BS, Ferrarotto R, Johnson FM, Mott FE, Gillison ML, Lu C, Le X, Blumenschein GR, Wong MK, Rosenthal DI, Nagarajan P, El-Naggar AK, Midgen MR, Weber RS, Myers JN, Gross ND. Cytotoxic and targeted systemic therapy in patients with advanced cutaneous squamous cell carcinoma in the head and neck. Head Neck 2021; 43:1592-1603. [PMID: 33522021 DOI: 10.1002/hed.26626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/07/2020] [Accepted: 01/20/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The outcomes of patients treated with cytotoxic or targeted systemic therapy is not well defined for cutaneous squamous cell carcinoma of the head and neck (cSCCHN). METHODS Patients with cSCCHN treated with cytotoxic or targeted systemic therapy were included. Patients were divided into two groups based on the presence of distant metastasis (M1 vs. M0) at presentation. A proportional hazards model was used to assess for independent predictors of overall survival. RESULTS Of 129 patients with cSCCHN, 20 (16%) were M1 and 109 (84%) were M0. Independent predictors of improved survival were M0 status, treatment of locally advanced disease with radiotherapy, and lower Eastern Cooperative Oncology Group (ECOG) score. CONCLUSIONS Survival was worse in M1 patients treated with cytotoxic or targeted systemic therapy and poor baseline performance status but improved in those receiving radiotherapy. These data can serve as historical controls for future systemic therapy trials, including immunotherapy.
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Affiliation(s)
- Samantha Tam
- Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System and Henry Ford Cancer Institute, Detroit, Michigan, USA
| | - Mona Gajera
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Xiaoning Luo
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Bonnie S Glisson
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Faye M Johnson
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Frank E Mott
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Maura L Gillison
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Charles Lu
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Xiuning Le
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - George R Blumenschein
- Division of Cancer Medicine, Department of Thoracic Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Michael K Wong
- Division of Cancer Medicine, Department of Melanoma Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - David I Rosenthal
- Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Division of Pathology/Lab Medicine, Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Adel K El-Naggar
- Division of Pathology/Lab Medicine, Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Michael R Midgen
- Division of Internal Medicine, Department of Dermatology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Randal S Weber
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey N Myers
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Neil D Gross
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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24
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Kampel L, Dorman A, Horowitz G, Fliss DM, Gutfeld O, Muhanna N. Surgically Treated Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck: Outcome Predictors and the Role of Adjuvant Radiation Therapy. Ann Otol Rhinol Laryngol 2021; 130:1016-1023. [PMID: 33514267 DOI: 10.1177/0003489421990182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Advanced cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is associated with poor outcome despite multimodality therapy. Comprehensive risk stratification may pinpoint the most suitable adjuvant treatment. This study aimed to evaluate the outcomes of surgically treated locoregional CSCCHN and to identify prognostic indicators of treatment outcomes. METHODS We retrospectively analyzed disease variables, pathologic characteristics, and management in association with treatment outcomes of all consecutive advanced CSCCHN patients who underwent surgical resection at Tel Aviv Sourasky Medical Center. RESULTS From 2008 to 2018, 74 patients met the inclusion criteria. Only perineural invasion (PNI) was significantly associated with worse overall survival (OS) (P = .001). Location within the facial "mask areas" was significantly associated with pathologically negative cervical disease (P = .001). Forty-seven patients underwent adjuvant radiation therapy (RT) which significantly improved OS and disease-free survival versus surgery alone (P = .025 and P = 0.035, respectively). CONCLUSION PNI was associated with worse OS in surgically treated advanced CSCCHN. Adjuvant RT conferred better outcomes despite high risk features.
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Affiliation(s)
- Liyona Kampel
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Alexandra Dorman
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Gilad Horowitz
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Dan M Fliss
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Orit Gutfeld
- Institute of Radiation Therapy, Division of Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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25
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Leiter U, Gutzmer R, Alter M, Ulrich C, Meiwes A, Heppt MV, Steeb T, Berking C, Lonsdorf AS, Sachse MM, Garbe C, Hillen U. [Cutaneous squamous cell carcinoma]. Hautarzt 2020; 71:597-606. [PMID: 32583034 DOI: 10.1007/s00105-020-04620-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers of the Caucasian population and accounts for 20% of all skin tumours. An S3 guideline of the German Guideline Program in Oncology has been available since 2019. The diagnosis is based on the clinical examination. Excision and histological confirmation is required for all clinically suspicious lesions to allow prognostic assessment and correct treatment. The therapy of first choice is complete excision with histological control of the surgical margin. In cSCC with risk factors such as tumor thickness >6 mm, sentinel lymph node biopsy may be discussed, but there is currently no clear evidence of its prognostic and therapeutic relevance. Adjuvant radiation therapy may be considered in cases of high risk of recurrence and should be tested in cases of inoperable tumors. The indication for electrochemotherapy should also be considered in the treatment of local or locoregional recurrence. The immune checkpoint inhibitor cemiplimab is approved for the treatment of inoperable or metastasized cSCC. In case of contraindications, chemotherapeutic agents, epidermal growth factor receptor (EGFR) inhibitors or palliative radiotherapy can be used. Since the evidence is low in these cases, a systemic therapy should be used preferentially within clinical studies. Follow-up care should be risk-adapted and includes a dermatological control, supplemented by ultrasound examinations in high-risk patients.
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Affiliation(s)
- U Leiter
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland.
| | - R Gutzmer
- Hauttumorzentrum Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - M Alter
- Universitätshautklinik, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - C Ulrich
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Meiwes
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - M V Heppt
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - T Steeb
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - C Berking
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - A S Lonsdorf
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - M M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven, Bremerhaven, Deutschland
| | - C Garbe
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - U Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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Recent and Emerging Therapies for Cutaneous Squamous Cell Carcinomas of the Head and Neck. Curr Treat Options Oncol 2020; 21:37. [PMID: 32328817 DOI: 10.1007/s11864-020-00739-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OPINION STATEMENT Cutaneous squamous cell carcinoma (cSCC) of the head and neck is typically managed with Mohs Micrographic Surgery (MMS) for cosmetic reasons. MMS also improves oncologic outcomes for high-risk tumors. Patients with certain high-risk subsets of the disease also benefit from adjuvant radiation therapy. The PD-1 inhibitor, cemiplimab, was recently approved for treatment of locally advanced and metastatic cSCC unamenable to curative surgery or radiation therapy after the drug demonstrated encouraging, durable response rates. Cemiplimab and other systemic immunotherapies are now being evaluated in clinical trials in the neoadjuvant and adjuvant settings as well. Localized immunotherapies are also being studied, including oncolytic viruses such as talimogene laherparepvec, a modified herpes simplex virus previously approved for the treatment of advanced cutaneous melanoma. Most importantly, multidisciplinary care is crucial in optimizing outcomes for patients with high-risk cSCC of the head and neck.
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Leiter U, Heppt MV, Steeb T, Amaral T, Bauer A, Becker JC, Breitbart E, Breuninger H, Diepgen T, Dirschka T, Eigentler T, Flaig M, Follmann M, Fritz K, Greinert R, Gutzmer R, Hillen U, Ihrler S, John SM, Kölbl O, Kraywinkel K, Löser C, Nashan D, Noor S, Nothacker M, Pfannenberg C, Salavastru C, Schmitz L, Stockfleth E, Szeimies R, Ulrich C, Welzel J, Wermker K, Garbe C, Berking C. S3 guideline for actinic keratosis and cutaneous squamous cell carcinoma (cSCC) – short version, part 2: epidemiology, surgical and systemic treatment of cSCC, follow‐up, prevention and occupational disease. J Dtsch Dermatol Ges 2020; 18:400-413. [DOI: 10.1111/ddg.14072] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Ulrike Leiter
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Markus V. Heppt
- Department of Dermatology and AllergologyUniversity Medical Center LMU Munich Munich Germany
- Department of DermatologyFriedrich Alexander University of Erlangen‐Nuremberg Erlangen Germany
| | - Theresa Steeb
- Department of Dermatology and AllergologyUniversity Medical Center LMU Munich Munich Germany
- Department of DermatologyFriedrich Alexander University of Erlangen‐Nuremberg Erlangen Germany
| | - Teresa Amaral
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Andrea Bauer
- Department of DermatologyCarl Gustav Carus University Medical Center Dresden Germany
| | - Jürgen C. Becker
- Department of DermatologyEssen University Medical Center Essen Germany
| | | | - Helmut Breuninger
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Thomas Diepgen
- Institute for Clinical Social MedicineHeidelberg University Medical Center Heidelberg Germany
| | - Thomas Dirschka
- CentroDerm Clinic and Medical Faculty of Witten Herdecke University Wuppertal Germany
| | - Thomas Eigentler
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Michael Flaig
- Department of Dermatology and AllergologyUniversity Medical Center LMU Munich Munich Germany
| | | | | | | | - Ralf Gutzmer
- Department of Dermatology and AllergyHanover Medical School Hanover Germany
| | - Uwe Hillen
- Department of Dermatology and VenereologyVivantes Medical Center Berlin‐Neukölln Germany
| | | | - Swen Malte John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück Osnabrück Germany
| | - Oliver Kölbl
- Department of Radiation OncologyRegensburg University Medical Center Regensburg Germany
| | | | - Christoph Löser
- Department of DermatologyLudwigshafen Medical Center Ludwigshafen Germany
| | - Dorothee Nashan
- Department of DermatologyDortmund Medical Center Dortmund Germany
| | - Seema Noor
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Monika Nothacker
- Association of Scientific Medical Societies in Germany (AWMF) Berlin Germany
| | - Christina Pfannenberg
- Department of Diagnostic and Interventional RadiologyUniversity Medical Center Tübingen Germany
| | | | - Lutz Schmitz
- Department of DermatologyRuhr University of Bochum Bochum Germany
| | | | - Rolf‐Markus Szeimies
- Department of DermatologyKnappschaftskrankenhaus Recklinghausen Recklinghausen Germany
| | - Claas Ulrich
- Department of DermatologyCharité University Medical Center Berlin Germany
| | - Julia Welzel
- Department of Dermatology and AllergologyUniversity of Augsburg Augsburg Germany
| | - Kai Wermker
- Department of Oral and Maxillofacial SurgeryOsnabrück Medical Center Osnabrück Germany
| | - Claus Garbe
- Department of DermatologyEberhard Karls University of Tübingen Tübingen Germany
| | - Carola Berking
- Department of Dermatology and AllergologyUniversity Medical Center LMU Munich Munich Germany
- Department of DermatologyFriedrich Alexander University of Erlangen‐Nuremberg Erlangen Germany
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Leiter U, Heppt MV, Steeb T, Amaral T, Bauer A, Becker JC, Breitbart E, Breuninger H, Diepgen T, Dirschka T, Eigentler T, Flaig M, Follmann M, Fritz K, Greinert R, Gutzmer R, Hillen U, Ihrler S, John SM, Kölbl O, Kraywinkel K, Löser C, Nashan D, Noor S, Nothacker M, Pfannenberg C, Salavastru C, Schmitz L, Stockfleth E, Szeimies RM, Ulrich C, Welzel J, Wermker K, Garbe C, Berking C. S3‐Leitlinie „Aktinische Keratose und Plattenepithelkarzinom der Haut“ – Kurzfassung, Teil 2: Epidemiologie, chirurgische und systemische Therapie des Plattenepithelkarzinoms, Nachsorge, Prävention und Berufskrankheit. J Dtsch Dermatol Ges 2020; 18:400-413. [PMID: 32291932 DOI: 10.1111/ddg.14072_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ulrike Leiter
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Markus V Heppt
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians--Universität München, München.,Klinik für Dermatologie, Universitätsklinikum Erlangen
| | - Theresa Steeb
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians--Universität München, München
| | - Teresa Amaral
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Andrea Bauer
- Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden
| | | | | | - Helmut Breuninger
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Thomas Diepgen
- Institut für klinische Sozialmedizin, Universität Heidelberg
| | | | - Thomas Eigentler
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Michael Flaig
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians--Universität München, München
| | | | | | | | - Ralf Gutzmer
- Klinik für Dermatologie, Medizinische Hochschule Hannover
| | - Uwe Hillen
- Klinik für Dermatologie, Vivantes Klinikum Neukölln, Berlin
| | | | - Swen Malte John
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück
| | - Oliver Kölbl
- Klinik für Strahlentherapie, Universitätsklinikum Regensburg
| | | | | | | | - Seema Noor
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Berlin
| | - Christina Pfannenberg
- Klinik für Diagnostische unter Interventionelle Radiologie, Eberhard-Karls-Universität Tübingen
| | | | - Lutz Schmitz
- Klinik für Dermatologie, Ruhr-Universität Bochum
| | | | | | - Claas Ulrich
- Klinik für Dermatologie, Charité - Universitätsmedizin Berlin
| | | | - Kai Wermker
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Klinikum Osnabrück
| | - Claus Garbe
- Klinik für Dermatologie, Eberhard-Karls-Universität Tübingen, Tübingen
| | - Carola Berking
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians--Universität München, München.,Klinik für Dermatologie, Universitätsklinikum Erlangen
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Harris BN, Pipkorn P, Nguyen KNB, Jackson RS, Rao S, Moore MG, Farwell DG, Bewley AF. Association of Adjuvant Radiation Therapy With Survival in Patients With Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck. JAMA Otolaryngol Head Neck Surg 2020; 145:153-158. [PMID: 30570645 DOI: 10.1001/jamaoto.2018.3650] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Importance Cutaneous squamous cell carcinoma (CSCC) is one of the most common malignant tumors worldwide. There is conflicting evidence regarding the indications for and benefits of adjuvant radiation therapy for advanced CSCC tumors of the head and neck. Objective To assess indications for adjuvant radiation therapy in patients with CSCC. Design, Setting, and Participants Retrospective analysis of 349 patients with head and neck CSCC treated with primary resection with or without adjuvant radiation therapy at 2 tertiary referral centers from January 1, 2008, to June 30, 2016. Main Outcomes and Measures Data were compared between treatment groups with a χ2 analysis. Disease-free survival (DFS) and overall survival (OS) were analyzed using a Kaplan-Meier survival analysis with log-rank test and a Cox proportional hazards multivariate regression. Results A total of 349 patients had tumors that met the inclusion criteria (mean [SD] age, 70 [12] years; age range, 32-94 years; 302 [86.5%] male), and 191 (54.7%) received adjuvant radiation therapy. The 5-year Kaplan-Meier estimates were 59.4% for DFS and 47.4% for OS. Patients with larger, regionally metastatic, poorly differentiated tumors with perineural invasion (PNI) and younger immunosuppressed patients were more likely to receive adjuvant radiation therapy. On Cox proportional hazards multivariate regression, patients with periorbital tumors (hazard ratio [HR], 2.48; 95% CI, 1.00-6.16), PNI (HR, 1.90; 95% CI, 1.12-3.19), or N2 or greater nodal disease (HR, 2.16; 95% CI, 1.13-4.16) had lower DFS. Immunosuppressed patients (HR, 2.17; 95% CI, 1.12-4.17) and those with N2 or greater nodal disease (HR, 2.43; 95% CI, 1.42-4.17) had lower OS. Adjuvant radiation therapy was associated with improved OS for the entire cohort (HR, 0.59; 95% CI, 0.38-0.90). In a subset analysis of tumors with PNI, adjuvant radiation therapy was associated with improved DFS (HR, 0.47; 95% CI, 0.23-0.93) and OS (HR, 0.44; 95% CI, 0.24-0.86). Adjuvant radiation therapy was also associated with improved DFS (HR, 0.36; 95% CI, 0.15-0.84) and OS (HR, 0.30; 95% CI, 0.15-0.61) in patients with regional disease. Conclusions and Relevance Among patients with advanced CSCC, receipt of adjuvant radiation therapy was associated with improved survival in those with PNI and regional disease.
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Affiliation(s)
- Brianna N Harris
- Department of Otolaryngology, University of California, Davis, Sacramento
| | - Patrik Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Ky Nam Bai Nguyen
- Department of Radiation Oncology, University of California, Davis, Sacramento
| | - Ryan S Jackson
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Shyam Rao
- Department of Radiation Oncology, University of California, Davis, Sacramento
| | - Michael G Moore
- Department of Otolaryngology, University of California, Davis, Sacramento
| | - D Gregory Farwell
- Department of Otolaryngology, University of California, Davis, Sacramento
| | - Arnaud F Bewley
- Department of Otolaryngology, University of California, Davis, Sacramento
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Sahovaler A, Krishnan RJ, Yeh DH, Zhou Q, Palma D, Fung K, Yoo J, Nichols A, MacNeil SD. Outcomes of Cutaneous Squamous Cell Carcinoma in the Head and Neck Region With Regional Lymph Node Metastasis: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2020; 145:352-360. [PMID: 30844021 DOI: 10.1001/jamaoto.2018.4515] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance There is a need to summarize the available evidence and provide quantitative data of the most important prognostic factors for patients with metastatic cutaneous squamous cell carcinoma of the head and neck region with regional lymph node metastasis (McSCCHN). Objective To undertake a PRISMA-compliant systematic review and meta-analysis of all published studies on the risk factors for overall survival (OS), locoregional control (LRC), locoregional recurrence (LRR), and disease-specific survival (DSS) for patients with McSCCHN. Data Sources PubMed, CINAHL, and Embase were searched from 1946 to August 2018 for English-language articles. Study Selection Inclusion criteria were randomized clinical trials or observational studies reporting on at least 10 patients with McSCCHN; studies analyzing 1 defined risk factor; reporting OS, LRC, LRR, or DSS; and clinical follow-up of 1 year of more. For the final analysis we included risk factors that were analyzed for the same outcome in at least 3 studies. Of the 2923 articles screened, 21 articles met the inclusion criteria. Data Extraction and Synthesis PRISMA guidelines were used for abstracting the data. Two reviewers independently abstracted the data. Risk of bias was estimated with the Newcastle-Ottawa Scale. Meta-analysis was performed using the random-effects model. All analysis took place between January and October 2018. Main Outcomes and Measures The primary end point was OS. Secondary end points included LRC, LRR, and DSS. Results A total of 20 observational studies and 1 randomized clinical trial were identified, representing 3534 patients (some reviewed articles reported no demographic characteristics), and were included in the analysis. Significant risk factors associated with OS were immunosuppression (hazard ratio [HR] of death, 2.66; 95% CI, 2.26-3.13), extracapsular spread (HR, 1.90; 95% CI, 1.12-3.23), adjuvant radiotherapy (HR, 0.45; 95% CI, 0.27-0.78), lymph node ratio (HR, 1.91; 95% CI, 1.09-3.35), and advanced age (HR, 1.03; 95% CI, 1.00-1.07). Immunosuppression (HR, 3.82; 95% CI, 2.47-5.92) and adjuvant radiotherapy (HR, 0.52; 95% CI, 0.33-0.84) were also significant risk factors for DSS. Conclusions and Relevance Immunosuppressed patients and those with extracapsular extension have poor prognosis. Adjuvant radiotherapy is associated with an improvement in OS. These risk factors will assist with better risk stratification and may also help to inform future clinical trials.
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Affiliation(s)
- Axel Sahovaler
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.,Head and Neck Surgery Unit, General Surgery Department, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Rohin J Krishnan
- Epidemiology and Biostatistics Department, Western University, London, Ontario, Canada
| | - David H Yeh
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Qi Zhou
- Research Methods and Clinical Impact Department, McMaster University, Hamilton, Ontario, Canada
| | - David Palma
- Department of Oncology, Western University, London, Ontario, Canada
| | - Kevin Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Anthony Nichols
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
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Trosman SJ, Zhu A, Nicolli EA, Leibowitz JM, Sargi ZB. High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: Risk Factors for Recurrence and Impact of Adjuvant Treatment. Laryngoscope 2020; 131:E136-E143. [PMID: 32065413 DOI: 10.1002/lary.28564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/09/2020] [Accepted: 01/23/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The behavior of advanced cutaneous squamous cell carcinoma of the head and neck (HNcSCC) remains poorly understood, with highly variable risk factors and a paucity of data for adjuvant treatment. The objective of our study was to review the oncologic outcomes of patients with high-risk HNcSCC treated with surgery and to identify risk factors for treatment failure. STUDY DESIGN Retrospective cohort study. METHODS Retrospective review of patients treated for HNcSCC with definitive surgery involving at least parotidectomy and neck dissection at a tertiary care academic center from 2011 to 2017 was conducted. The primary outcome was disease-free survival (DFS). RESULTS One-hundred four patients with a median age of 68 years (range = 42-91 years) were reviewed. Twenty-one patients were treated with surgery alone, 45 patients underwent adjuvant radiotherapy (RT), and 38 patients underwent adjuvant chemoradiotherapy (CRT). The 2-year DFS for patients treated with surgery, surgery + RT, and surgery + CRT were 71%, 65%, and 58%, respectively, with no significant difference between the groups (P = .70). On multivariate analyses, tumor size (P = .006) and perineural invasion (PNI, P = .04) independently predicted recurrence. The addition of chemotherapy did not appear to improve DFS, neither for those patients with extranodal extension and/or positive margins (P = .93) nor for the entire cohort (P = .43). CONCLUSIONS Advanced HNcSCC has a high recurrence rate despite adjuvant treatment. Tumor size >2 cm was a strong independent risk factor for recurrence. Out of the traditional mucosal HNcSCC risk factors, PNI was most strongly associated with worse DFS. There was no observed survival benefit to the addition of chemotherapy. LEVEL OF EVIDENCE 4. Laryngoscope, 131:E136-E143, 2021.
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Affiliation(s)
- Samuel J Trosman
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela Zhu
- University of Miami Miller School of Medicine, Miami, Florida
| | - Elizabeth A Nicolli
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Jason M Leibowitz
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Zoukaa B Sargi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
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McDowell L, Yom SS. Locally advanced non-melanomatous skin cancer: Contemporary radiotherapeutic management. Oral Oncol 2019; 99:104443. [DOI: 10.1016/j.oraloncology.2019.104443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022]
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Gutzmer R, Wiegand S, Kölbl O, Wermker K, Heppt M, Berking C. Actinic Keratosis and Cutaneous Squamous Cell Carcinoma. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 116:616-626. [PMID: 32048593 PMCID: PMC6819699 DOI: 10.3238/arztebl.2019.0616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 03/29/2019] [Accepted: 07/04/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) and its precursors, actinic keratoses (AK), are common. Physicians of multiple specialties are confronted with their treatment. METHODS This review is based on publications retrieved by a selective search in PubMed, as well as on the German guidelines on AK and cSCC, skin cancer prevention, and surgery with histologic guidance. RESULTS Local treatments for AK include lesional cryotherapy, curettage, and laser ablation as well as field-directed treatments with topical agents, e.g., diclofenac plus hyaluronic acid, imiquimod, 5-fluorouracil, ingenol mebutate, and photodynamic therapy. These treatments can be administered in various sequences or combinations, depending on individual factors and the stage of the disease. The gold standard of treatment for cSCC is histologically confirmed complete resection; radiotherapy is an alternative. Locally uncontrollable or metastatic disease is treated with systemic drugs. The use of various chemotherapeutic agents, EGFR-directed therapies, and the PD-I inhibitor cemiplimab, either singly or in combination, has been described in uncontrolled trials and case series. Cemiplimab has a reported response rate of 47% and was recently approved for the treatment of advanced cSCC. CONCLUSION There are many options for the treatment of AK and cSCC that must be considered in the interdisciplinary care of these entities.
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Affiliation(s)
- Ralf Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology, Hannover Medical School
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig
| | - Oliver Kölbl
- Department of Radiotherapy, University Hospital Regensburg
| | - Kai Wermker
- Department of Oromaxillofacial, Plastic and Esthetic Surgery, Osnabrück Hospital GmbH, Osnabrück
| | - Markus Heppt
- Department of Dermatology and Allergology, University Hospital (LMU), Munich
| | - Carola Berking
- Department of Dermatology and Allergology, University Hospital (LMU), Munich
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López PA, Pedraza M, Moreno A, García O, Buitrago R, Mogollon G, Fory L, Conrado H. Multidisciplinary management of giant cervicothoracic cutaneous squamous cell carcinoma. Int J Surg Case Rep 2019; 61:294-297. [PMID: 31401438 PMCID: PMC6699553 DOI: 10.1016/j.ijscr.2019.07.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022] Open
Abstract
Non treated squamous cell carcinoma could present as an uncontrollable and substantial disaurement neoplasm. Squamous cell carcinoma that are diagnosed early and successfully treated by surgical excision, has a better forecast. When a patient present with a gigant squamous cell carcinoma always requires a multidisciplinary team.
Introduction Cutaneus squamous cell carcinoma (SCC) is the second most common type of nonmelanoma skin cancer. SCC is a malignant neoplasm of the skin characterized by aberrant proliferation of keratinocytes. Presentation case We report multidisciplinary surgical management of a 36-year-old male who presented with a huge cutaneous protruding tumor of the cervicothoracic wall. Clinically, he presented with a growing mass on the anterior cervicothoracic wall 3 years ago. Microscopic examination revealed SCC. He underwent complete excision of the lesion. The patient neglected attending our oncological department for receiving chemotherapy. Today, one year after surgery, he is alive without evidence of disease recurrence. Discussion SCC treatment depends on location of the lesion, involvement of neighboring structures, functional level of the patient, and the patient’s acceptance of the proposed management strategy. Conclusion We conclude that SCC can grow to a huge size if left untreated. Surgery by a multidisciplinary surgical team is the primary mode of treatment, followed by chemotherapy if necessary.
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Affiliation(s)
- P A López
- Department of General Surgery, Bosque University, Colombia; Bosque University, Colombia
| | - M Pedraza
- Department of General Surgery, Bosque University, Colombia; Bosque University, Colombia.
| | - A Moreno
- Department of Head and Neck Surgery, National Institute of Cancer, Bogotá, Colombia; National Institute of Cancer, Bogotá, Colombia; Bosque University, Colombia
| | - O García
- Department of Soft Tissue and Breast, National Institute of Cancer, Bogotá, Colombia; National Institute of Cancer, Bogotá, Colombia
| | - R Buitrago
- Department of Thorax Surgery, National Institute of Cancer, Bogotá, Colombia; National Institute of Cancer, Bogotá, Colombia
| | - G Mogollon
- Department of Head and Neck Surgery, National Institute of Cancer, Bogotá, Colombia
| | - L Fory
- Department of General Surgery, Universidad Militar Central, Bogotá, Colombia
| | - H Conrado
- South Colombian University, Colombia
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Riihilä P, Nissinen L, Knuutila J, Rahmati Nezhad P, Viiklepp K, Kähäri VM. Complement System in Cutaneous Squamous Cell Carcinoma. Int J Mol Sci 2019; 20:ijms20143550. [PMID: 31331124 PMCID: PMC6678994 DOI: 10.3390/ijms20143550] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 12/16/2022] Open
Abstract
Epidermal keratinocyte-derived cutaneous squamous cell carcinoma (cSCC) is the most common metastatic skin cancer with high mortality rates in the advanced stage. Chronic inflammation is a recognized risk factor for cSCC progression and the complement system, as a part of innate immunity, belongs to the microenvironment of tumors. The complement system is a double-edged sword in cancer, since complement activation is involved in anti-tumor cytotoxicity and immune responses, but it also promotes cancer progression directly and indirectly. Recently, the role of several complement components and inhibitors in the regulation of progression of cSCC has been shown. In this review, we will discuss the role of complement system components and inhibitors as biomarkers and potential new targets for therapeutic intervention in cSCC.
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Affiliation(s)
- Pilvi Riihilä
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Liisa Nissinen
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Jaakko Knuutila
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Pegah Rahmati Nezhad
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Kristina Viiklepp
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Veli-Matti Kähäri
- Department of Dermatology, University of Turku and Turku University Hospital, Hämeentie 11 TE6, FI-20520 Turku, Finland.
- The Western Cancer Centre of the Cancer Center Finland (FICAN West), University of Turku and Turku University Hospital, Kiinamyllynkatu 10, FI-20520 Turku, Finland.
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36
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Sang Y, Deng Y. Current insights into the epigenetic mechanisms of skin cancer. Dermatol Ther 2019; 32:e12964. [PMID: 31081988 DOI: 10.1111/dth.12964] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/25/2019] [Accepted: 05/06/2019] [Indexed: 12/23/2022]
Abstract
Skin cancer is a manifestation of tumors. The different types of skin cancer are named according to their source of tumor cells. Currently, there are three main types of skin cancer. They are squamous cell carcinoma, basal cell carcinoma, and melanoma. Their epidemiological characteristics, clinical classifications, and treatment methods are somewhat different. The epigenetic modifications are also different in these three types of skin cancer. Epigenetics is the change in gene expression and function and the generation of a heritable phenotype without changing the DNA sequence. The phenomenon of epigenetics involves a variety of processes, including the methylation of DNA and RNA, histone modifications, RNAi, and chromatin remodeling. Researchers have found that DNA, RNA, histone, and chromatin level modifications cause heritable changes in gene expression patterns. This review will introduce the role of epigenetics in skin cancer from the three following angles: DNA methylation, histone modifications, and RNA methylation.
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Affiliation(s)
- Yanqi Sang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yu Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
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Chen WC, Li QL, Pan Q, Zhang HY, Fu XY, Yao F, Wang JN, Yang AK. Xenotropic and polytropic retrovirus receptor 1 (XPR1) promotes progression of tongue squamous cell carcinoma (TSCC) via activation of NF-κB signaling. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:167. [PMID: 30995931 PMCID: PMC6469095 DOI: 10.1186/s13046-019-1155-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/27/2019] [Indexed: 01/15/2023]
Abstract
Background Xenotropic and polytropic retrovirus receptor 1 (XPR1), a previously identified cellular receptor for several murine leukemia viruses, plays a role in many pathophysiological processes. However, the role of XPR1 in human cancers has not yet been characterized. Methods Real-time PCR and western blotting assay were used to measure the expression of XPR1 in tongue squamous cell carcinoma (TSCC) tissues. Expression of XPR1 and p65 in clinical specimens was analyzed using immunohistochemical assay. The function of XPR1 on progression of TSCC was explored using in vitro and in vivo experiments. The molecular mechanism by which XPR1 helps to cancer progression was investigated by luciferase reporter activity, ELISA, PKA activity assay, immunofluorescence, western blotting and qPCR assay. Results Herein, we find that XPR1 is markedly upregulated in TSCC tissues compared to normal tongue tissues. High expression of XPR1 significantly correlates with the malignant features and poor patient survival in TSCC. Ectopic expression of XPR1 increases, while silencing of XPR1 reduces the proliferation, invasion and anti-apoptosis capacities of TSCC cells. Importantly, silencing of XPR1 effectively inhibits the tumorigenecity of TSCC cells. Moreover, we identified that XPR1 increased the concentration of intracellular cAMP and activated PKA. Thus, XPR1 promoted phosphorylation and activation of NF-κB signaling, which is required for XPR1-mediated oncogenic roles and significantly correlates with XPR1 expression in clinical specimens. Conclusions These findings uncover a critical role of XPR1 in TSCC progression via activation of NF-κB, and suggest that XPR1 might be a potential prognostic marker or therapeutic target. Electronic supplementary material The online version of this article (10.1186/s13046-019-1155-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei-Chao Chen
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Qiu-Li Li
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Qimei Pan
- Guangzhou Yousheng Biotech Co., Ltd., Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hua-Yong Zhang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiao-Yan Fu
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Fan Yao
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jian-Ning Wang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Institute of Stomatological Research, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong Province, 510055, People's Republic of China.
| | - An-Kui Yang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China. .,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China. .,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.
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38
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Perineural Invasion and Perineural Tumor Spread in Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019; 103:1109-1124. [DOI: 10.1016/j.ijrobp.2018.12.009] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/18/2018] [Accepted: 12/01/2018] [Indexed: 01/03/2023]
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Abstract
Skin cancer represents a broad classification of malignancies, which can be further refined by histology, including basal cell carcinoma, squamous cell carcinoma and melanoma. As these three cancers are distinct entities, we review each one separately, with a focus on their epidemiology, etiology including relevant genomic data, and the current evidence-based recommendations for adjuvant and neoadjuvant therapy. We also discuss future directions and opportunities for continued therapeutic advances.
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Affiliation(s)
- Assuntina G Sacco
- Division of Hematology-Oncology, University of California San Diego, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0658, USA.
| | - Gregory A Daniels
- Division of Hematology-Oncology, University of California San Diego, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0658, USA
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DeCesaris C, Amin NP, Hundal J, Vujaskovic Z, Agarwal M. Hyperthermia and Hyper-fractionated Radiation for a Cutaneous Squamous Cell Carcinoma Progressing on Standard Therapy: A Case Report. Adv Radiat Oncol 2019; 4:4-9. [PMID: 30706002 PMCID: PMC6349596 DOI: 10.1016/j.adro.2018.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cristina DeCesaris
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Neha P Amin
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Zeljko Vujaskovic
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Manuj Agarwal
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
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41
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Does Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck Warrant Adjuvant Treatment After Surgical Resection? DIFFICULT DECISIONS IN SURGERY: AN EVIDENCE-BASED APPROACH 2019. [DOI: 10.1007/978-3-030-15123-2_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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42
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Senghore T, Chien HT, Wang WC, Chen YX, Young CK, Huang SF, Yeh CC. Polymorphisms in ERCC5 rs17655 and ERCC1 rs735482 Genes Associated with the Survival of Male Patients with Postoperative Oral Squamous Cell Carcinoma Treated with Adjuvant Concurrent Chemoradiotherapy. J Clin Med 2019; 8:jcm8010033. [PMID: 30609649 PMCID: PMC6351919 DOI: 10.3390/jcm8010033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/19/2018] [Accepted: 12/25/2018] [Indexed: 01/13/2023] Open
Abstract
The nucleotide excision repair (NER) pathway plays a major role in the repair of DNA damaged by exogenous agents, such as chemotherapeutic and radiotherapeutic agents. Thus, we investigated the association between key potentially functional single nucleotide polymorphisms (SNPs) in the NER pathway and clinical outcomes in oral squamous cell carcinoma (OSCC) patients treated with concurrent chemoradiotherapy (CCRT). Thirteen SNPs in five key NER genes were genotyped in 319 male OSCC patients using iPLEX MassARRAY. Cox proportional hazards models and Kaplan–Meier survival curves were used to estimate the risk of death or recurrence. Carriers of the XPC rs2228000 TT genotype showed a borderline significant increased risk of poor overall survival under the recessive model (hazard ratio (HR) = 1.81, 95% confidence interval (CI) = 0.99–3.29). The CC genotypes of ERCC5 rs17655 (HR = 1.54, 95% CI = 1.03–2.29) and ERCC1 rs735482 (HR = 1.65, 95% CI = 1.06–2.58) were associated with an increased risk of worse disease-free survival under the recessive model. In addition, participants carrying both the CC genotypes of ERCC5 rs17655 and ERCC1 rs735482 exhibited an enhanced susceptibility for recurrence (HR = 2.60, 95% CI = 1.11–6.09). However, no statistically significant interaction was observed between them. Our findings reveal that the ERCC5 rs17655 CC and ERCC1 rs735482 CC genotypes were associated with an increased risk of recurrence in male patients with OSCC treated with CCRT. Therefore, CCRT may not be beneficial, and alternative treatments are required for such patients.
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Affiliation(s)
- Thomas Senghore
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Nursing, School of Medicine and Allied Health Sciences, University of The Gambia, Independence Drive, Banjul, P.O. Box 1646, The Gambia.
| | - Huei-Tzu Chien
- Department of Public Health, Chang Gung University, Tao-Yuan 33305, Taiwan.
- Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan 33302, Taiwan.
| | - Wen-Chang Wang
- Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
| | - You-Xin Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
| | - Chi-Kuang Young
- Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan.
| | - Shiang-Fu Huang
- Department of Public Health, Chang Gung University, Tao-Yuan 33305, Taiwan.
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan.
| | - Chih-Ching Yeh
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Public Health, College of Public Health, China Medical University, Taichung 40402, Taiwan.
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Zhang X, Yu F, Zhao Z, Mai J, Zhou Y, Tan G, Liu X. The Prognostic Significance of Lymph Node Ratio and Log Odds Ratio in Laryngeal Squamous Cell Carcinoma. OTO Open 2018; 2:2473974X18792008. [PMID: 31535064 PMCID: PMC6737873 DOI: 10.1177/2473974x18792008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate whether lymph node ratio (LNR) and log odds ratio (LODDS) have prognostic significance for overall survival (OS) and disease-free survival (DFS) in patients with laryngeal squamous cell cancer (LSCC) treated with curative intent. Study Design Case-control study. Setting University hospital. Subjects and Methods Records of 229 patients with LSCC who underwent surgery with a curative intent with or without adjuvant treatment from 2000 to 2014 were reviewed. The clinicopathological parameters LNR and LODDS were analyzed; univariate and multivariate analysis was performed to evaluate the prognosis of each for OS and DFS. Results The 5-year OS was 81.7% for LNR ≤0.233 and 47.1% for LNR >0.233, and the 5-year OS was 79.6% for LODDS ≤–0.1 and 51.8% for LODDS >–0.1, respectively. In the univariate analysis, the independent variables were subsites, pT stage (pT1 and pT2 vs pT3 and pT4), pN, pTNM, alcohol consumption, and LNR and LODDS (P < .05). By multivariate analysis, we determined that subsites, pT stage, alcohol consumption, LNR, and LODDS were independent prognostic predictors of survival (P < .05). Univariate and multivariate models identified that both LNR and LODDS were significant prognostic factors for survival. However, the hazard ratio (HR) for LNR >0.233 vs ≤0.233 was 8.95 (95% confidence interval [CI], 3.18-25.16; P < .001) in OS, and the HR was 11.37 (95% CI, 4.02-32.15; P < .001) in DFS. The risk of LNR was noticeably greater than other factors. Conclusions LNR and LODDS were both prognostic factors for OS and DFS. However, LNR was confirmed as a more reliable indicator for evaluating the prognosis, and it can be used to increase the prognostic value of the traditional TNM classification of LSCC.
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Affiliation(s)
- Xinrui Zhang
- Department of Otorhinolaryngology, Guangzhou Otolaryngology-Head and Neck Surgery Hospital, Guangzhou, Guangdong, P.R. China.,Institute of Otolaryngology-Head and Neck Surgery, Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Feng Yu
- Department of Otorhinolaryngology, Guangzhou Otolaryngology-Head and Neck Surgery Hospital, Guangzhou, Guangdong, P.R. China.,Institute of Otolaryngology-Head and Neck Surgery, Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Zheng Zhao
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, P.R. China.,Department of Head and Neck Surgery, Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
| | - Junhao Mai
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, P.R. China.,Department of Head and Neck Surgery, Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
| | - Yibo Zhou
- Department of Otorhinolaryngology, Guangzhou Otolaryngology-Head and Neck Surgery Hospital, Guangzhou, Guangdong, P.R. China.,Institute of Otolaryngology-Head and Neck Surgery, Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Guojie Tan
- Department of Otorhinolaryngology, Guangzhou Otolaryngology-Head and Neck Surgery Hospital, Guangzhou, Guangdong, P.R. China.,Institute of Otolaryngology-Head and Neck Surgery, Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Xuekui Liu
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, P.R. China.,Department of Head and Neck Surgery, Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
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Amoils M, Kim J, Lee C, Sunwoo JB, Colevas AD, Aasi SZ, Hollmig ST, Ma Y, Divi V. PD-L1 Expression and Tumor-Infiltrating Lymphocytes in High-Risk and Metastatic Cutaneous Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2018; 160:93-99. [PMID: 30012051 DOI: 10.1177/0194599818788057] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To characterize programmed death-ligand 1 (PD-L1) expression and tumor-infiltrating lymphocyte (TIL) positivity for locally aggressive or regionally metastatic cutaneous head and neck squamous cell carcinoma (cHNSCC). STUDY DESIGN Retrospective chart review, followed by immunohistochemical staining of archived tumor specimens. SETTING Tertiary academic medical center. SUBJECTS AND METHODS After identification of 101 patients treated surgically for locally advanced or regionally metastatic cHNSCC, archived tissue was stained and graded for PD-L1 expression in addition to TIL presence. Cross-tabulation was performed to examine the association between either of these variables and clinicopathologic features and outcomes. RESULTS A total of 101 patients met inclusion criteria, but archived tissue was available only for 83 (31 primaries, 52 metastases). The majority of primary tumors demonstrated grade 1 PD-L1 staining, while grade 2 staining was more likely for metastases. Neither high- nor low-grade PD-L1 expression correlated with any clinicopathologic variable for primary tumors. However, for metastases, high-grade staining was significantly associated with regional recurrence (15 of 19, P = .02). TILs were present for 65% of primary tumors and 90% of regional metastases but did not correlate with any clinicopathologic variables. CONCLUSION Diffuse expression of PD-L1 in this study highlights the possibility of using immunotherapy in the form of programmed death 1/PD-L1 blockade to improve treatment for this devastating disease. However, further studies are needed to clarify the significance of PD-L1 expression and TIL positivity for locally advanced or regionally metastatic cHNSCC.
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Affiliation(s)
- Misha Amoils
- 1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Jinah Kim
- 2 Department of Dermatology, Stanford University, Stanford, California, USA
| | - Carolyn Lee
- 2 Department of Dermatology, Stanford University, Stanford, California, USA
| | - John B Sunwoo
- 1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - A Dimitrios Colevas
- 3 Division of Oncology, Stanford Department of Medicine, Stanford Cancer Center, Stanford University, Stanford, California, USA
| | - Sumaira Z Aasi
- 2 Department of Dermatology, Stanford University, Stanford, California, USA
| | - S Tyler Hollmig
- 2 Department of Dermatology, Stanford University, Stanford, California, USA
| | - Yifei Ma
- 1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Vasu Divi
- 1 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
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Cañueto J, Jaka A, Toll A. The Value of Adjuvant Radiotherapy in Cutaneous Squamous Cell Carcinoma: A Review. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.adengl.2018.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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46
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Cañueto J, Jaka A, Toll A. The Value of Adjuvant Radiotherapy in Cutaneous Squamous Cell Carcinoma: A Review. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:476-484. [PMID: 29759308 DOI: 10.1016/j.ad.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/05/2018] [Accepted: 03/19/2018] [Indexed: 12/24/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in humans and its incidence is rising. Although surgery is the treatment of choice for cSCC, postoperative adjuvant radiotherapy has an important role in local and locorregional disease control. In this review, we analyze the value of postoperative radiotherapy in the management of high-risk cSCC (in particular, cases with perineural invasion), cSCC with positive surgical margins, and locally advanced cSCC (with parotid gland and/or lymph node metastasis).
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Affiliation(s)
- J Cañueto
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, IBSAL Instituto de Investigación Biomédica de Salamanca, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - A Jaka
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - A Toll
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, España.
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Porceddu SV, Bressel M, Poulsen MG, Stoneley A, Veness MJ, Kenny LM, Wratten C, Corry J, Cooper S, Fogarty GB, Collins M, Collins MK, Macann AMJ, Milross CG, Penniment MG, Liu HYH, King MT, Panizza BJ, Rischin D. Postoperative Concurrent Chemoradiotherapy Versus Postoperative Radiotherapy in High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: The Randomized Phase III TROG 05.01 Trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2017.77.0941] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To report the results of the Trans Tasman Radiation Oncology Group randomized phase III trial designed to determine whether the addition of concurrent chemotherapy to postoperative radiotherapy (CRT) improved locoregional control in patients with high-risk cutaneous squamous cell carcinoma of the head and neck. Patients and Methods The primary objective was to determine whether there was a difference in freedom from locoregional relapse (FFLRR) between 60 or 66 Gy (6 to 6.5 weeks) with or without weekly carboplatin (area under the curve 2) after resection of gross disease. Secondary efficacy objectives were to compare disease-free survival and overall survival. Results Three hundred twenty-one patients were randomly assigned, with 310 patients commencing allocated treatment (radiotherapy [RT] alone, n = 157; CRT, n = 153). Two hundred thirty-eight patients (77%) had high-risk nodal disease, 59 (19%) had high-risk primary or in-transit disease, and 13 (4%) had both. Median follow-up was 60 months. Median RT dose was 60 Gy, with 84% of patients randomly assigned to CRT completing six cycles of carboplatin. The 2- and 5-year FFLRR rates were 88% (95% CI, 83% to 93%) and 83% (95% CI, 77% to 90%), respectively, for RT and 89% (95% CI, 84% to 94%) and 87% (95% CI, 81% to 93%; hazard ratio, 0.84; 95% CI, 0.46 to 1.55; P = .58), respectively, for CRT. There were no significant differences in disease-free or overall survival. Locoregional failure was the most common site of first treatment failure, with isolated distant metastases as the first site of failure seen in 7% of both arms. Treatment was well tolerated in both arms, with no observed enhancement of RT toxicity with carboplatin. Grade 3 or 4 late toxicities were infrequent. Conclusion Although surgery and postoperative RT provided excellent FFLRR, there was no observed benefit with the addition of weekly carboplatin.
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Affiliation(s)
- Sandro Virgilio Porceddu
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Mathias Bressel
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Michael Geoffrey Poulsen
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Adam Stoneley
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Michael John Veness
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Lizbeth Moira Kenny
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Chris Wratten
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - June Corry
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Stephen Cooper
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Gerald Blaise Fogarty
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Marnie Collins
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Michael Kevin Collins
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Andrew Martin John Macann
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Christopher Gerard Milross
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Michael Gordon Penniment
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Howard Yu-hao Liu
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Madeleine Trudy King
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Benedict James Panizza
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
| | - Danny Rischin
- Sandro Virgilio Porceddu, Michael Geoffrey Poulsen, Lizbeth Moira Kenny, and Benedict James Panizza, University of Queensland; Sandro Virgilio Porceddu, Adam Stoneley, Howard Yu-hao Liu, and Benedict James Panizza, Princess Alexandra Hospital; Michael Geoffrey Poulsen, Radiation Oncology Mater Centre; Lizbeth Moira Kenny, Royal Brisbane and Women’s Hospital, Brisbane; Michael Kevin Collins, Townsville Cancer Centre and James Cook University, Townsville, Queensland; Mathias Bressel, June Corry, Marnie
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48
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Bhatia AK, Burtness BA, Decker RH. Postoperative Chemoradiation in High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck. J Clin Oncol 2018; 36:1269-1271. [DOI: 10.1200/jco.2018.77.7987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aarti K. Bhatia
- Aarti K. Bhatia, Barbara A. Burtness, and Roy H. Decker, Yale School of Medicine, Yale Cancer Center, New Haven, CT
| | - Barbara A. Burtness
- Aarti K. Bhatia, Barbara A. Burtness, and Roy H. Decker, Yale School of Medicine, Yale Cancer Center, New Haven, CT
| | - Roy H. Decker
- Aarti K. Bhatia, Barbara A. Burtness, and Roy H. Decker, Yale School of Medicine, Yale Cancer Center, New Haven, CT
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49
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Wang LS, Handorf EA, Ridge JA, Burtness BA, Lango MN, Mehra R, Liu JC, Galloway TJ. Lymph-node-positive cutaneous nonmelanoma skin cancer: A poor-prognosis disease in need of treatment intensification. EAR, NOSE & THROAT JOURNAL 2018; 96:E12-E18. [PMID: 28719713 DOI: 10.1177/014556131709600703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Locoregionally advanced nonmelanoma skin cancer (NMSC) has an aggressive clinical course characterized by high rates of treatment failure and poor survival compared with localized skin cancers. Our goal was to investigate multimodal therapy for lymph-node-positive NMSC. Data from patients with lymph-node-positive NMSC who underwent surgery and adjuvant therapy at a single tertiary center from 2002 to 2012 were retrospectively reviewed. Median follow-up was 1.8 years (range: 0.5 to 8.5). Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method. The chi-square test and logistic regression were used to determine the association between locoregional control (LRC) and the following variables: evidence of extracapsular extension, number of lymph nodes positive, largest involved lymph node, presence of a positive margin, and use of concurrent chemoradiation (CRT). Forty-six patients were evaluated, 13 (28%) of whom received adjuvant CRT. CRT patients were younger (p < 0.001) and had a significantly greater number of positive lymph nodes (p = 0.016) than patients who received adjuvant radiation alone. At 5 years, LRC was 76%, PFS was 65%, and OS was 49%. Univariate analysis demonstrated that CRT (p = 0.006), largest lymph node measurement (p = 0.039), and ≥3 involved lymph nodes (p = 0.001) predicted local recurrence. CRT (p = 0.035, odds ratio [OR] 0.20 [95% confidence interval 0.05 to 0.90]) and ≥3 involved lymph nodes (p = 0.017, OR 0.07 [95% confidence interval 0.01 to 0.62]) remained significant on multivariate analysis. CRT was well tolerated. No grade ≥3 toxicities were observed except for 1 asymptomatic grade-4 thrombocytopenia. Patients with lymph-node-positive NMSC do poorly. Patient selection for intensification of adjuvant therapy needs clarification.
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Affiliation(s)
- Lora S Wang
- Department of Radiation Oncology, 333 Cottman Ave., Philadelphia, PA 19111-2497, USA
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50
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Cutaneous squamous cell carcinoma. J Am Acad Dermatol 2018; 78:249-261. [DOI: 10.1016/j.jaad.2017.08.058] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/23/2017] [Accepted: 08/17/2017] [Indexed: 11/19/2022]
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