A 5-year follow-up study of 633 cutaneous SCC excisions: Rates of local recurrence and lymph node metastasis. Issue 8 (August 2018)

• Record Type: Journal Article
• Authors: Khan, K.; Mykula, R.; Kerstein, R.; Rabey, N.; Bragg, T.; Crick, A.; Heppell, S.; Budny, P.; Potter, M.
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 71:Issue 8(2018)
• Page Start: 1153
• Page End: 1158
• Publication Date: 2018-08
• Subjects: Squamous cell carcinoma -- SCC -- Recurrence rate -- Local recurrence -- Lymph node metastases; Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2018.03.019
• Languages: English
• ISSNs: 1748-6815

Abstract

Summary: Background: A 5-year follow-up study of 633 cutaneous squamous cell cancer (SCC) excisions was performed by collecting data on rates of local recurrence (LR) and lymph node (LN) metastasis. Methods: A retrospective analysis of patients was performed across four regional plastic surgery centres (Stoke Mandeville Hospital, Aylesbury; John Radcliffe Hospital, Oxford; Salisbury District Hospital, Salisbury and Queen Alexandra Hospital, Portsmouth) assessing rates of LR and LN metastasis. Results: We report 5-year outcomes from 598 SCCs (95% follow-up rate). The total recurrence rate (LR and LN metastasis) was 6.7% (n = 40) at 5 years, with 96% of these occurring within 2 years. Median time to LR was 9 months (1–57), with 76.9% (n = 20) undergoing further wide local excision. Median time to LN metastasis was 5.5 months (1–18 months). There were two cases of disease-related death. Only 15% (n = 6) of incomplete excisions recurred. Interestingly, 19.1% (n = 9) of 47 SCCs with perineural invasion on original histopathology recurred versus only 5.6% (n = 31) of the 551 SCCs without perineural invasion (p = 0.005). Conclusions: This study is one of the largest studies to date following up 598 SCC excisions at 5 years with total recurrence rates comparable to those in current published literature. We report perineural invasion as a significant predictor of recurrence and that 96% of total recurrence occurred within 2 years. This is in contrast to current UK guidelines (75% at 2 years, 95% at 5 years), thus suggesting that shorter length of hospital follow-up may be reasonable.