ABSTRACT NUMBER: NESTAC_05
Timothy Shun Man Chu1, Chad Chang2, Sahan Rannan-Eliya2
Newcastle University1. Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary2.
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MAIN ABSTRACT TEXT
Squamous cell carcinoma (SCC) is the second commonest form of skin cancer. The British Association of Dermatologists (BAD) states that metastatic rate for primary cutaneous SCC (pcSCC) is around 10% overall and that high-risk pcSCCs should be monitored for at least 2 years. We aim to assess the metastatic rate, identify key risk factors that predict metastasis, and determine the time-to-presentation for metastatic cases, in order to review the current guidelines.
This research involves two study arms. The primary arm retrospectively examines all pcSCCs resected/biopsied during a 6-month period in 2012 and assesses for metastasis at 5 years. The metastatic arm focuses on all metastatic cases from 2012-2018, reviewing their initial histopathology and time-to-presentation. Findings are then compared to the current guideline and existing literature.
272 pcSCCs were identified in the primary arm. 205 (75.4%) were high-risk according to BAD guideline and the metastatic rate was 1.47% (n=4). The metastatic arm included 45 SCCs. 73.9% (n=34) and 89.1% (n=41) presented within 2 years and 5 years from primary diagnosis, respectively.
As per some recent studies, we report a lower metastatic rate compared with BAD guideline. Tumour depth of at least 2mm was found to be a significant risk factor for metastasis in this study. Our findings on the time-to-presentation of metastatic cases were similar to the current guideline (75% at 2 years, 95% at 5 years) although some studies suggested otherwise. Evaluation and potential revision of the 10-year guideline based on more recent studies is recommended.