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

Piyush Grover, Stephanie Flukes, Angela Jacques, Samuel Leedman, Andrew Lindsay, Rohen White, Peter Friedland, Reuven Gurfinkel, Annette M Lim

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

AIM: To examine the clinicopathological features, mortality and morbidity in high-risk cutaneous squamous cell carcinoma (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: 129/ 141 patients 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 non-melanoma skin cancer (57%) with advanced disease (57% stage IV without distant metastasis, AJCC 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 non-metastatic 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 health-care associated interventions. There is an unmet need for robust cancer data collection. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)944-951
Number of pages8
JournalInternal Medicine Journal
Volume52
Issue number6
Early online date20 Nov 2021
DOIs
Publication statusPublished - Jun 2022

Fingerprint

Dive into the research topics of 'Clinicopathological characteristics and clinical morbidity in high-risk head and neck cutaneous squamous cell carcinoma patients in Western Australia'. Together they form a unique fingerprint.

Cite this