Adjuvant radiation following clear margin resection of high T-stage cutaneous squamous cell carcinoma halves the risk of local and locoregional recurrence: A dual-center retrospective study - 14/06/22
, Kylee J.B. Kus, BS a, b, Timothy D. Smile, MD c, Fadi Murad, MD, MPH a, Guohai Zhou, PhD d, Evelyn O. Ilori, MD, PhD c, e, Jonathan D. Schoenfeld, MD, MPH f, Danielle N. Margalit, MD, MPH f, Roy B. Tishler, MD, PhD f, Allison T. Vidimos, MD g, Shlomo A. Koyfman, MD c, Chrysalyne D. Schmults, MD, MSCE aAbstract |
Background |
Although adjuvant radiation (ART) following clear margin surgery is recommended for select high-risk cutaneous squamous cell carcinomas, efficacy data are limited.
Objective |
To evaluate the impact of ART on outcomes following clear margin surgery for high T-stage cutaneous squamous cell carcinomas.
Methods |
A 20-year retrospective cohort study at 2 academic centers of high T-stage cutaneous squamous cell carcinomas (Brigham and Women’s Hospital T2b or T3) with negative histologic margins post resection. Local recurrence (LR) and locoregional recurrence (LRR) were compared by whether tumors received ART or observation.
Results |
A total of 508 tumors were included, of which 96 underwent ART (ART+). ART+ had a lower 5-year cumulative incidence of LR (ART+, 3.6% [95% CI, 1.6%-7.7%] vs ART−, 8.7% [95% CI, 6.3%-12.0%]) and LRR (ART+, 7.5% [95% CI, 4.4%-11.9%] vs ART−, 15.3% [95% CI, 11.9%-22.1%]). Recurrent tumors ≥6 cm or Brigham and Women’s Hospital T3 tumors were classified as high-risk due to a higher 5-year cumulative incidence of LRR (High-risk, 26.3% [95% CI, 19.0%-35.7%]). High-risk tumors treated with ART had a lower 5-year cumulative incidence of LRR (ART+, 17.2% [95% CI, 11.9%-26.4%] vs ART−, 31.0% [95% CI, 26.1%-40.8%]).
Limitations |
Retrospective design, heterogeneous population, variations in radiation protocols.
Conclusion |
ART following clear margin surgery for high T-stage cutaneous squamous cell carcinomas resulted in half the risk of LR and LRR.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous squamous cell carcinoma, radiation, recurrence
Abbreviations used : ART, BWH, CSCC, DSD, LCNI, LR, LRR, LVI, NM, PNI, SHR
Plan
| Drs Ruiz and Kus are cofirst authors. |
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| Drs Koyfman and Schmults are cosenior authors. |
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| Funding sources: Supported in part by the Melvin Markey Discovery Fund at Cleveland Clinic. |
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| IRB approval status: Approved by the Massachusetts General Brigham Human Research Office and the Cleveland Clinic Institutional Review Board. |
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| Reprints not available from the authors. |
Vol 87 - N° 1
P. 87-94 - juillet 2022 Retour au numéro
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