Risk factors and timing of subsequent cutaneous squamous cell carcinoma in patients with cutaneous squamous cell carcinoma: a retrospective cohort study
Marla Rodriguez, BS • Brandon T. Beal, MD • Manisha Manmohan, MD • Isaac N. Briskin, MA • Thomas Knackstedt, MD • Allison T. Vidimos, MD, RPh
Published: August 26, 2020 DOI:https://doi.org/10.1016/j.jaad.2020.08.083
Information about the frequency and timing of subsequent cutaneous squamous cell carcinoma (cSCC), along with associated risk factors, is limited. However, this information is crucial to guide follow-up care for these patients.
Evaluate the risk and timing of subsequent cSCC in patients who presented with initial diagnosis of cSCC.
Retrospective review of IRB-approved single institution registry of invasive cSCC. All patients had at least two primary cSCCs diagnosed on two separate dates 2-months apart.
299 primary cSCCs were included. 6-months from initial cSCC diagnosis, 18.06%(n=54) of patients developed subsequent cSCC; at 1-year 31.77%(n=94), 3-years 67.56%(n=202), and 5-years 87.96%(n=263) developed subsequent cSCC. Risk factors associated with subsequent cSCC include age at initial diagnosis (HR=1.02, 95% CI=[1.004, 1.027], p=0.008), T2 stage (HR=1.66, 95% CI=[1.07, 2.57], p=0.025), and poor tumor grade. Tumor grades well, moderate, and unknown have HRs of 0.21 (p = <0.001), 0.16 (p = <0.001), and 0.25 (p = 0.001), respectively.
Of patients that develop subsequent cSCC, 18.06% do so within 6-months and 31.77% do so within 1-year of initial cSCC diagnosis. Patients with advanced age, poor histologic differentiation, and AJCC T2 stage are at highest risk. Close clinical follow-up after initial diagnosis is recommended.