Cargando…

Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia

BACKGROUND: There is no registry data on morbidity and mortality of high‐risk cutaneous squamous cell carcinoma (cSCC) in Australia. AIM: To examine the clinicopathological features, mortality and morbidity in high‐risk cSCC patients in Western Australia (WA). METHODS: A retrospective cohort study w...

Descripción completa

Detalles Bibliográficos
Autores principales: Grover, Piyush, Flukes, Stephanie, Jacques, Angela, Leedman, Samuel, Lindsay, Andrew, White, Rohen, Friedland, Peter, Gurfinkel, Reuven, Lim, Annette M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324086/
https://www.ncbi.nlm.nih.gov/pubmed/34800329
http://dx.doi.org/10.1111/imj.15630
_version_ 1784756720926457856
author Grover, Piyush
Flukes, Stephanie
Jacques, Angela
Leedman, Samuel
Lindsay, Andrew
White, Rohen
Friedland, Peter
Gurfinkel, Reuven
Lim, Annette M.
author_facet Grover, Piyush
Flukes, Stephanie
Jacques, Angela
Leedman, Samuel
Lindsay, Andrew
White, Rohen
Friedland, Peter
Gurfinkel, Reuven
Lim, Annette M.
author_sort Grover, Piyush
collection PubMed
description BACKGROUND: There is no registry data on morbidity and mortality of high‐risk cutaneous squamous cell carcinoma (cSCC) in Australia. AIM: To examine the clinicopathological features, mortality and morbidity in high‐risk cSCC patients in Western Australia (WA). METHODS: A retrospective cohort study was conducted through hospital record review on cSCC patients discussed at multidisciplinary meetings at the two largest WA hospitals between March 2015 and December 2016. RESULTS: Of 141 patients, 129 were evaluable, with median follow up of 43.9 (range 3.0–53.2) months. Patients were predominantly older males (84%) with significant comorbidities (Charlson Comorbidity Index (CCI) ≥5; 76%) and history of previous nonmelanoma skin cancer (57%) with advanced disease (57% stage IV without distant metastasis; American Joint Committee on Cancer, 7th edition). Pathological high‐risk features were common including nodal extracapsular extension (47%) and cranial nerve involvement (16%). Clinical morbidity was significant with a median of 2 (range 0–13) excisions and 2 (range 0–21) cSCC‐related hospitalisations for any cSCC event following the index case discussion. Recurrences of the primary index lesion occurred in 60% of patients and 20% had ≥2 recurrences. Median overall survival for patients with nonmetastatic disease was 39.8 (range 25.9–53.7) months and 16.1 (range 0.2–32.0) months for metastatic disease. CCI ≥5, advanced nodal stage and ≥2 recurrences were significantly associated with mortality on multivariable analyses (P < 0.05). Nodal extracapsular extension and any recurrences were identified as significant risk factors for disease‐specific mortality on multivariable analyses (P < 0.05). CONCLUSION: High‐risk cSCC patients have significant health needs represented by high‐baseline comorbidities, multiplicity of cSCC events and the number of healthcare‐associated interventions. There is an unmet need for robust cancer data collection.
format Online
Article
Text
id pubmed-9324086
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley & Sons Australia, Ltd
record_format MEDLINE/PubMed
spelling pubmed-93240862022-07-30 Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia Grover, Piyush Flukes, Stephanie Jacques, Angela Leedman, Samuel Lindsay, Andrew White, Rohen Friedland, Peter Gurfinkel, Reuven Lim, Annette M. Intern Med J Original Articles BACKGROUND: There is no registry data on morbidity and mortality of high‐risk cutaneous squamous cell carcinoma (cSCC) in Australia. AIM: To examine the clinicopathological features, mortality and morbidity in high‐risk cSCC patients in Western Australia (WA). METHODS: A retrospective cohort study was conducted through hospital record review on cSCC patients discussed at multidisciplinary meetings at the two largest WA hospitals between March 2015 and December 2016. RESULTS: Of 141 patients, 129 were evaluable, with median follow up of 43.9 (range 3.0–53.2) months. Patients were predominantly older males (84%) with significant comorbidities (Charlson Comorbidity Index (CCI) ≥5; 76%) and history of previous nonmelanoma skin cancer (57%) with advanced disease (57% stage IV without distant metastasis; American Joint Committee on Cancer, 7th edition). Pathological high‐risk features were common including nodal extracapsular extension (47%) and cranial nerve involvement (16%). Clinical morbidity was significant with a median of 2 (range 0–13) excisions and 2 (range 0–21) cSCC‐related hospitalisations for any cSCC event following the index case discussion. Recurrences of the primary index lesion occurred in 60% of patients and 20% had ≥2 recurrences. Median overall survival for patients with nonmetastatic disease was 39.8 (range 25.9–53.7) months and 16.1 (range 0.2–32.0) months for metastatic disease. CCI ≥5, advanced nodal stage and ≥2 recurrences were significantly associated with mortality on multivariable analyses (P < 0.05). Nodal extracapsular extension and any recurrences were identified as significant risk factors for disease‐specific mortality on multivariable analyses (P < 0.05). CONCLUSION: High‐risk cSCC patients have significant health needs represented by high‐baseline comorbidities, multiplicity of cSCC events and the number of healthcare‐associated interventions. There is an unmet need for robust cancer data collection. John Wiley & Sons Australia, Ltd 2022-04-06 2022-06 /pmc/articles/PMC9324086/ /pubmed/34800329 http://dx.doi.org/10.1111/imj.15630 Text en © 2021 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Grover, Piyush
Flukes, Stephanie
Jacques, Angela
Leedman, Samuel
Lindsay, Andrew
White, Rohen
Friedland, Peter
Gurfinkel, Reuven
Lim, Annette M.
Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title_full Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title_fullStr Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title_full_unstemmed Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title_short Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia
title_sort clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in western australia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324086/
https://www.ncbi.nlm.nih.gov/pubmed/34800329
http://dx.doi.org/10.1111/imj.15630
work_keys_str_mv AT groverpiyush clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT flukesstephanie clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT jacquesangela clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT leedmansamuel clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT lindsayandrew clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT whiterohen clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT friedlandpeter clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT gurfinkelreuven clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia
AT limannettem clinicopathologicalcharacteristicsandclinicalmorbidityinhighriskheadandneckcutaneoussquamouscellcarcinomapatientsinwesternaustralia