Emily Stamell Ruiz1, Pritesh S Karia1, Frederick C Morgan1, Chrysalyne D Schmults2. 1. Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: cschmults@partners.org.
Abstract
BACKGROUND: There is limited evidence on the utility of radiologic imaging for prognostic staging of cutaneous squamous cell carcinoma (CSCC). OBJECTIVE: Review utilization of radiologic imaging of high-stage CSCCs to evaluate whether imaging impacted management and outcomes. METHODS: Tumors classified as Brigham and Women's Hospital (BWH) tumor (T) stage T2B or T3 over a 13-year period were reviewed to identify whether imaging was performed and whether results affected treatment. Disease-related outcomes (DRO: local recurrence, nodal metastasis, death from disease) were compared between patients by type of imaging used. RESULTS: 108 high-stage CSCCs in 98 patients were included. Imaging (mostly computed tomography, 79%) was utilized in 45 (46%) patients and management was altered in 16 (33%) patients who underwent imaging. Patients that received no imaging were at higher risk of developing nodal metastases (nonimaging, 30%; imaging, 13%; P = .041) and any DRO (nonimaging, 42%; imaging, 20%; P = .028) compared to the imaging group. Imaging was associated with a lower risk for DRO (subhazard ratio, 0.5; 95% CI 0.2-0.9; P = .046) adjusted for BWH T stage, sex, and location. LIMITATIONS: Single institution retrospective design and changes in technology overtime. CONCLUSIONS: Radiologic imaging of high-stage CSCC may influence management and appears to positively impact outcomes. Further prospective studies are needed to establish which patients benefit from imaging.
BACKGROUND: There is limited evidence on the utility of radiologic imaging for prognostic staging of cutaneous squamous cell carcinoma (CSCC). OBJECTIVE: Review utilization of radiologic imaging of high-stage CSCCs to evaluate whether imaging impacted management and outcomes. METHODS: Tumors classified as Brigham and Women's Hospital (BWH) tumor (T) stage T2B or T3 over a 13-year period were reviewed to identify whether imaging was performed and whether results affected treatment. Disease-related outcomes (DRO: local recurrence, nodal metastasis, death from disease) were compared between patients by type of imaging used. RESULTS: 108 high-stage CSCCs in 98 patients were included. Imaging (mostly computed tomography, 79%) was utilized in 45 (46%) patients and management was altered in 16 (33%) patients who underwent imaging. Patients that received no imaging were at higher risk of developing nodal metastases (nonimaging, 30%; imaging, 13%; P = .041) and any DRO (nonimaging, 42%; imaging, 20%; P = .028) compared to the imaging group. Imaging was associated with a lower risk for DRO (subhazard ratio, 0.5; 95% CI 0.2-0.9; P = .046) adjusted for BWH T stage, sex, and location. LIMITATIONS: Single institution retrospective design and changes in technology overtime. CONCLUSIONS: Radiologic imaging of high-stage CSCC may influence management and appears to positively impact outcomes. Further prospective studies are needed to establish which patients benefit from imaging.
Authors: J Claveau; J Archambault; D S Ernst; C Giacomantonio; J J Limacher; C Murray; F Parent; D Zloty Journal: Curr Oncol Date: 2020-08-01 Impact factor: 3.677
Authors: Matthew Fox; Marc Brown; Nicholas Golda; Dori Goldberg; Christopher Miller; Melissa Pugliano-Mauro; Chrysalyne Schmults; Thuzar Shin; Thomas Stasko; Yaohui G Xu; Kishwer Nehal Journal: J Am Acad Dermatol Date: 2018-09-15 Impact factor: 11.527
Authors: Ignazio Stanganelli; Francesco Spagnolo; Giuseppe Argenziano; Paolo A Ascierto; Franco Bassetto; Paolo Bossi; Vittorio Donato; Daniela Massi; Cesare Massone; Roberto Patuzzo; Giovanni Pellacani; Pietro Quaglino; Paola Queirolo; Iris Zalaudek; Giuseppe Palmieri Journal: Cancers (Basel) Date: 2022-01-13 Impact factor: 6.639