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Management of Local Recurrence and In-Transit Metastasis

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High-Risk Cutaneous Squamous Cell Carcinoma

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Abstract

Recurrent squamous cell carcinoma is an aggressive entity that often carries a poor prognosis. Metastasis rates between 30 and 50 % have been reported, significantly higher than primary disease. Early recognition and management of disease is critical to minimizing patient morbidity and mortality. An understanding of those who may be at risk for recurrent disease is an important first step. Risk factor criteria include variables such as tumor size, depth of invasion, differentiation/growth pattern, location, neural involvement, recurrent disease, and patient comorbidities. Depending on extent of disease, management options include surgical and non-surgical options, and/or their combination. In certain situations, a multi-disciplinary setting involving specialists from Mohs surgery, medical oncology, head and neck surgery or surgical oncology, and radiation oncology may be required to offer the best prognosis. In this chapter, we will review diagnosis, and management of recurrent SCC. An additional section on a recently described and related entity known as in-transit metastases is also included.

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References

  1. Rowe DE, Carroll RJ, Day Jr CL. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol. 1992;26(6):976–90.

    Article  CAS  PubMed  Google Scholar 

  2. Tavin E, Persky M. Metastatic cutaneous squamous cell carcinoma of the head and neck region. Laryngoscope. 1996;106(2 Pt 1):156–8.

    Article  CAS  PubMed  Google Scholar 

  3. Brantsch KD, Meisner C, Schonfisch B, Trilling B, Wehner-Caroli J, Rocken M, et al. Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study. Lancet Oncol. 2008;9(8):713–20.

    Article  PubMed  Google Scholar 

  4. Eroglu A, Camlibel S. Risk factors for locoregional recurrence of scar carcinoma. Br J Surg. 1997;84(12):1744–6.

    Article  CAS  PubMed  Google Scholar 

  5. Brodland DG, Zitelli JA. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. 1992;27(2 Pt 1):241–8.

    Article  CAS  PubMed  Google Scholar 

  6. Khan AA, Potter M, Cubitt JJ, Khoda BJ, Smith J, Wright EH, et al. Guidelines for the excision of cutaneous squamous cell cancers in the United Kingdom: the best cut is the deepest. J Plast Reconstr Aesthet Surg. 2013;66(4):467–71.

    Article  CAS  PubMed  Google Scholar 

  7. Tan PY, Ek E, Su S, Giorlando F, Dieu T. Incomplete excision of squamous cell carcinoma of the skin: a prospective observational study. Plast Reconstr Surg. 2007;120(4):910–6.

    Article  CAS  PubMed  Google Scholar 

  8. Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, Vidimos AT, et al. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol. 2012;67(4):531–50.

    Article  PubMed  Google Scholar 

  9. Miller SJ, Alam M, Andersen J, Berg D, Bichakjian CK, Bowen G, et al. Basal cell and squamous cell skin cancers. J Natl Compr Canc Netw. 2010;8(8):836–64.

    PubMed  Google Scholar 

  10. Leibovitch I, Huilgol SC, Selva D, Hill D, Richards S, Paver R. Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia II. Perineural invasion. J Am Acad Dermatol. 2005;53(2):261–6.

    Article  PubMed  Google Scholar 

  11. Pugliano-Mauro M, Goldman G. Mohs surgery is effective for high-risk cutaneous squamous cell carcinoma. Dermatol Surg. 2010;36(10):1544–53.

    Article  CAS  PubMed  Google Scholar 

  12. Leibovitch I, Huilgol SC, Selva D, Hill D, Richards S, Paver R. Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia I. Experience over 10 years. J Am Acad Dermatol. 2005;53(2):253–60.

    Article  PubMed  Google Scholar 

  13. Dzubow LM, Rigel DS, Robins P. Risk factors for local recurrence of primary cutaneous squamous cell carcinomas. Treatment by microscopically controlled excision. Arch Dermatol. 1982;118(11):900–2.

    Article  CAS  PubMed  Google Scholar 

  14. Silapunt S, Peterson SR, Goldberg LH. Squamous cell carcinoma of the auricle and Mohs micrographic surgery. Dermatol Surg. 2005;31(11 Pt 1):1423–7.

    CAS  PubMed  Google Scholar 

  15. Kwan W, Wilson D, Moravan V. Radiotherapy for locally advanced basal cell and squamous cell carcinomas of the skin. Int J Radiat Oncol Biol Phys. 2004;60(2):406–11.

    Article  PubMed  Google Scholar 

  16. Locke J, Karimpour S, Young G, Lockett MA, Perez CA. Radiotherapy for epithelial skin cancer. Int J Radiat Oncol Biol Phys. 2001;51(3):748–55.

    Article  CAS  PubMed  Google Scholar 

  17. Cranmer LD, Engelhardt C, Morgan SS. Treatment of unresectable and metastatic cutaneous squamous cell carcinoma. Oncologist. 2010;15(12):1320–8.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sadek H, Azli N, Wendling JL, Cvitkovic E, Rahal M, Mamelle G, et al. Treatment of advanced squamous cell carcinoma of the skin with cisplatin, 5-fluorouracil, and bleomycin. Cancer. 1990;66(8):1692–6.

    Article  CAS  PubMed  Google Scholar 

  19. Cartei G, Cartei F, Interlandi G, Meneghini G, Jop A, Zingone G, et al. Oral 5-fluorouracil in squamous cell carcinoma of the skin in the aged. Am J Clin Oncol. 2000;23(2):181–4.

    Article  CAS  PubMed  Google Scholar 

  20. Bentzen JD, Hansen HS. Phase II analysis of paclitaxel and capecitabine in the treatment of recurrent or disseminated squamous cell carcinoma of the head and neck region. Head Neck. 2007;29(1):47–51.

    Article  PubMed  Google Scholar 

  21. Harwood CA, Leedham-Green M, Leigh IM, Proby CM. Low-dose retinoids in the prevention of cutaneous squamous cell carcinomas in organ transplant recipients: a 16-year retrospective study. Arch Dermatol. 2005;141(4):456–64.

    Article  CAS  PubMed  Google Scholar 

  22. Wright TI, Spencer JM, Flowers FP. Chemoprevention of nonmelanoma skin cancer. J Am Acad Dermatol. 2006;54(6):933–46. quiz 47–50.

    Article  PubMed  Google Scholar 

  23. Lippman SM, Parkinson DR, Itri LM, Weber RS, Schantz SP, Ota DM, et al. 13-Cis-retinoic acid and interferon alpha-2a: effective combination therapy for advanced squamous cell carcinoma of the skin. J Natl Cancer Inst. 1992;84(4):235–41.

    Article  CAS  PubMed  Google Scholar 

  24. Brewster AM, Lee JJ, Clayman GL, Clifford JL, Reyes MJ, Zhou X, et al. Randomized trial of adjuvant 13-cis-retinoic acid and interferon alfa for patients with aggressive skin squamous cell carcinoma. J Clin Oncol. 2007;25(15):1974–8.

    Article  CAS  PubMed  Google Scholar 

  25. Shin DM, Glisson BS, Khuri FR, Clifford JL, Clayman G, Benner SE, et al. Phase II and biologic study of interferon alfa, retinoic acid, and cisplatin in advanced squamous skin cancer. J Clin Oncol. 2002;20(2):364–70.

    Article  CAS  PubMed  Google Scholar 

  26. Nanney LB, Magid M, Stoscheck CM, King Jr LE. Comparison of epidermal growth factor binding and receptor distribution in normal human epidermis and epidermal appendages. J Invest Dermatol. 1984;83(5):385–93.

    Article  CAS  PubMed  Google Scholar 

  27. Shimizu T, Izumi H, Oga A, Furumoto H, Murakami T, Ofuji R, et al. Epidermal growth factor receptor overexpression and genetic aberrations in metastatic squamous-cell carcinoma of the skin. Dermatology. 2001;202(3):203–6.

    Article  CAS  PubMed  Google Scholar 

  28. Bauman JE, Eaton KD, Martins RG. Treatment of recurrent squamous cell carcinoma of the skin with cetuximab. Arch Dermatol. 2007;143(7):889–92.

    Article  CAS  PubMed  Google Scholar 

  29. Suen JK, Bressler L, Shord SS, Warso M, Villano JL. Cutaneous squamous cell carcinoma responding serially to single-agent cetuximab. Anticancer Drugs. 2007;18(7):827–9.

    Article  CAS  PubMed  Google Scholar 

  30. Arnold AW, Bruckner-Tuderman L, Zuger C, Itin PH. Cetuximab therapy of metastasizing cutaneous squamous cell carcinoma in a patient with severe recessive dystrophic epidermolysis bullosa. Dermatology. 2009;219(1):80–3.

    Article  PubMed  Google Scholar 

  31. Maubec E, Petrow P, Scheer-Senyarich I, Duvillard P, Lacroix L, Gelly J, et al. Phase II study of cetuximab as first-line single-drug therapy in patients with unresectable squamous cell carcinoma of the skin. J Clin Oncol. 2011;29(25):3419–26.

    Article  CAS  PubMed  Google Scholar 

  32. El-Sawy T, Sabichi AL, Myers JN, Kies MS, William WN, Glisson BS, et al. Epidermal growth factor receptor inhibitors for treatment of orbital squamous cell carcinoma. Arch Ophthalmol. 2012;130(12):1608–11.

    Article  PubMed  Google Scholar 

  33. Lewis CM, Glisson BS, Feng L, Wan F, Tang X, Wistuba II, et al. A phase II study of gefitinib for aggressive cutaneous squamous cell carcinoma of the head and neck. Clin Cancer Res. 2012;18(5):1435–46.

    Article  CAS  PubMed  Google Scholar 

  34. Yin VT, Pfeiffer ML, Esmaeli B. Targeted therapy for orbital and periocular basal cell carcinoma and squamous cell carcinoma. Ophthal Plast Reconstr Surg. 2013;29(2):87–92.

    Article  PubMed  Google Scholar 

  35. Berg D, Otley CC. Skin cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol. 2002;47(1):1–17. quiz 8–20.

    Article  PubMed  Google Scholar 

  36. Martinez JC, Otley CC, Stasko T, Euvrard S, Brown C, Schanbacher CF, et al. Defining the clinical course of metastatic skin cancer in organ transplant recipients: a multicenter collaborative study. Arch Dermatol. 2003;139(3):301–6.

    Article  PubMed  Google Scholar 

  37. Carucci JA, Martinez JC, Zeitouni NC, Christenson L, Coldiron B, Zweibel S, et al. In-transit metastasis from primary cutaneous squamous cell carcinoma in organ transplant recipients and nonimmunosuppressed patients: clinical characteristics, management, and outcome in a series of 21 patients. Dermatol Surg. 2004;30(4 Pt 2):651–5.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY, USA

    Vitaly Terushkin MD & John A. Carucci MD, PhD

Authors
  1. Vitaly Terushkin MD
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  2. John A. Carucci MD, PhD
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Corresponding authors

Correspondence to Vitaly Terushkin MD or John A. Carucci MD, PhD .

Editor information

Editors and Affiliations

  1. Brigham & Women's Hosp., Dept of Derm., Mohs & Dermatologic Surgery Center, Jamaica Plain, Massachusetts, USA

    Chrysalyne D. Schmults

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Terushkin, V., Carucci, J.A. (2016). Management of Local Recurrence and In-Transit Metastasis. In: Schmults, C. (eds) High-Risk Cutaneous Squamous Cell Carcinoma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47081-7_7

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  • DOI: https://doi.org/10.1007/978-3-662-47081-7_7

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47080-0

  • Online ISBN: 978-3-662-47081-7

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