Timothy D Smile1, David X Xiong2,3, Vamsi Varra2,4, Ian W Winter5, Brandon T Beal6, Brian R Gastman7, Jessica L Geiger8, David J Adelstein8, Wilma F Bergfeld9, Melissa P Piliang9, Steven D Billings9, Jennifer S Ko9, Thomas J Knackstedt10, Jennifer L Lucas7, Christina M Poblete-Lopez7, Jon G Meine7, Alok Vij7, Allison T Vidimos7, Shlomo A Koyfman5. 1. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, U.S.A.; smilet@ccf.org. 2. College of Medicine, Case Western Reserve University, Cleveland, OH, U.S.A. 3. Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A. 4. Department of Internal Medicine, University Hospitals Medical Center, Cleveland, OH, U.S.A. 5. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, U.S.A. 6. Jacksonville Skin Cancer Specialists, Jacksonville, FL, U.S.A. 7. Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, OH, U.S.A. 8. Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, U.S.A. 9. Institute of Pathology, Cleveland Clinic, Cleveland, OH, U.S.A. 10. Department of Dermatology, MetroHealth Hospital, Cleveland, OH, U.S.A.
Abstract
BACKGROUND/AIM: Satellitosis/in-transit metastasis (S-ITM) has prognostic value in melanoma and Merkel cell carcinoma, but is not incorporated into cutaneous squamous cell carcinoma (cSCC) staging. PATIENTS AND METHODS: From our IRB-approved registry, patients with high-risk cSCC, including patients with S-ITM, were identified. Univariate (UVA) and multivariate (MVA) analyses were performed to compare disease progression (DP) and overall survival (OS). Cumulative incidence of DP and OS analyses were performed using Fine-Gray and Kaplan-Meier methods, respectively. RESULTS: A total of 18 S-ITM subjects were compared to 247 high risk subjects including T3N0 (n=143), N1-N3 without extranodal extension (ENE) (n=56), N1-N3 with ENE (n=26) and M1 disease (n=22). Median follow up was 16.5 months. Three-year rates of DP were 22% for T3N0, 42% for S-ITM, 48% for T4 bone invasion, 50% for N1-N3 without extranodal extension (ENE), 53% for N1-N3 with ENE, and 66% for M1. Patients with S-ITM did not experience significantly worse DP compared to those with T3N0 (HR=1.96, 95%CI=0.8-4.9; p=0.14). CONCLUSION: Cutaneous SCC patients with S-ITM experienced outcomes similar to locally advanced non-metastatic cSCC patients. Larger studies are needed to guide incorporation into staging systems. Copyright
BACKGROUND/AIM: Satellitosis/in-transit metastasis (S-ITM) has prognostic value in melanoma and Merkel cell carcinoma, but is not incorporated into cutaneous squamous cell carcinoma (cSCC) staging. PATIENTS AND METHODS: From our IRB-approved registry, patients with high-risk cSCC, including patients with S-ITM, were identified. Univariate (UVA) and multivariate (MVA) analyses were performed to compare disease progression (DP) and overall survival (OS). Cumulative incidence of DP and OS analyses were performed using Fine-Gray and Kaplan-Meier methods, respectively. RESULTS: A total of 18 S-ITM subjects were compared to 247 high risk subjects including T3N0 (n=143), N1-N3 without extranodal extension (ENE) (n=56), N1-N3 with ENE (n=26) and M1 disease (n=22). Median follow up was 16.5 months. Three-year rates of DP were 22% for T3N0, 42% for S-ITM, 48% for T4 bone invasion, 50% for N1-N3 without extranodal extension (ENE), 53% for N1-N3 with ENE, and 66% for M1. Patients with S-ITM did not experience significantly worse DP compared to those with T3N0 (HR=1.96, 95%CI=0.8-4.9; p=0.14). CONCLUSION:Cutaneous SCCpatients with S-ITM experienced outcomes similar to locally advanced non-metastatic cSCC patients. Larger studies are needed to guide incorporation into staging systems. Copyright
Authors: Guilherme Rabinowits; Michael R Migden; Todd E Schlesinger; Robert L Ferris; Morganna Freeman; Valerie Guild; Shlomo Koyfman; Anna C Pavlick; Neil Swanson; Gregory T Wolf; Scott M Dinehart Journal: JID Innov Date: 2021-08-25