Squamous Cell Carcinoma with Regional Metastasis to Axilla or Groin Lymph Nodes: a Multicenter Outcome Analysis
| Autor: | George Pang, Daniel J. Kagedan, Suzana Kupper, Frances C. Wright, Lucy Helyer, May Lynn Quan, Nicole J. Look Hong, Gabrielle Paull, Johanna Dobransky, Carolyn Nessim, Scott Hurton |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Oncology medicine.medical_specialty Skin Neoplasms Groin Metastasis 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Humans Medicine Survival rate Aged Retrospective Studies business.industry Proportional hazards model Mortality rate Odds ratio Prognosis medicine.disease Combined Modality Therapy Survival Rate Axilla medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female 030211 gastroenterology & hepatology Surgery Lymph Nodes Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology. 26:4642-4650 |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | Cutaneous squamous cell carcinoma (cSCC) of the trunk/extremities with nodal metastasis represents a rare but significant clinical challenge. Treatment patterns and outcomes are poorly described. Patients with cSCC who developed axilla/groin lymph node metastasis and underwent curative-intent surgery between 2005 and 2015 were identified at four Canadian academic centers. Demographics, tumor characteristics, treatment patterns, recurrence rates, and mortality were described. Overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan–Meier analysis. Predictors of survival and any recurrence were explored using Cox regression and logistic regression models, respectively. Of 43 patients, 70% were male (median age 74 years). Median follow-up was 38 months. Median time to nodal metastasis was 11.3 months. Thirty-one and 12 patients had nodal metastasis to the axilla and groin, respectively. A total of 72% and 7% received adjuvant and neoadjuvant radiation, respectively, while 5% received adjuvant chemotherapy. Following surgery, 26% patients developed nodal and/or distant disease recurrence. Crude mortality rate was 39.5%. Mean OS was 5.3 years [95% confidence interval (CI) 3.9–6.8 years], and 5-year OS was 55.1%. Mean DFS was 4.8 years (95% CI 3.3–6.2 years), and five-year DFS was 49.3%. Any recurrence was the only independent predictor of death [p = 0.036, odds ratio (OR) = 29.5], and extracapsular extension (p = 0.028, OR = 189) and age (p = 0.017, OR = 0.823) were independent predictors of recurrence. This represents the largest contemporary series to date of outcomes for patients with axilla/groin nodal metastases from cSCC. Despite aggressive treatment, outcomes remain modest, indicating the need for a continued multidisciplinary approach and integration of new systemic agents. |
| Databáze: | OpenAIRE |
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