Thickness Predicts Squamous-Cell Carcinoma Spread

Only tumors thicker than 2 mm metastasized in study; other risk factors include horizontal size

THURSDAY, July 10 (HealthDay News) -- Factors predicting metastasis of cutaneous squamous-cell carcinoma include tumor thickness, horizontal size and location at the ear, according to research published online July 9 in The Lancet Oncology.

Kay D. Brantsch, M.D., of the Eberhard Karls University in Tubingen, Germany, and colleagues analyzed data from 615 white patients who underwent surgery for cutaneous squamous-cell carcinoma. Subjects were followed for a mean 43 months for metastasis or local recurrence.

Only squamous-cell carcinoma thicker than 2 millimeters have a significant risk of metastasis, the investigators found. Risk factors for metastasis were increased thickness (hazard ratio 4.79), immunosuppression (HR, 4.32), localization at the ear (HR, 3.61), and increased horizontal size (HR, 2.22). Risk factors for local recurrence were increased thickness (HR, 6.03) and desmoplasia (HR, 16.11), the report indicates.

"Our data showed the predictive accuracy of tumor staging that involves tumor thickness is better than the current tumor node metastasis classification of non-melanoma skin cancers," the authors write. "Our findings suggest the tumor node metastasis staging system for cutaneous squamous-cell carcinoma should consider tumor thickness, immunosuppression, and the presence or absence of desmoplasia, instead of Broders' grading."

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