Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

High Risk SCC and Mohs Micrographic Surgery

J Am Acad Dermatol; ePub 2018 Sep 19; Marrazzo, et al

Invasion beyond subcutaneous fat and poor histologic differentiation may carry a greater risk of poor outcomes than other factors in high risk cutaneous squamous cell carcinoma (hrSCC), according to a recent study. However, Mohs surgery alone provides excellent marginal control with low rates of local recurrence, nodal metastasis, and disease-specific death. Researchers conducted a retrospective chart review of all hrSCC patients treated in a clinic from October 2011 to December 2015, and found:

  • 647 hrSCC tumors that met inclusion criteria were identified.
  • During the follow-up period, there were 19 local recurrences(LR) (2.9%), 31 nodal metastases(NM) (4.8%), 7 distant metastases(DM) (1.1%), and 7 disease-specific deaths(DSD) (1.1%).
  • 2 factors—poor differentiation and invasion beyond the subcutaneous fat—were positively associated with local recurrence, nodal metastasis, and disease-specific death through multivariate analysis.

Marrazzo G, Zitelli JA, Brodland D. Clinical outcomes in high-risk squamous cell carcinoma patients treated with Mohs micrographic surgery alone. [Published online ahead of print September 19, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.09.015.

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