Abstract 1067P
Background
Despite clinical and histopathological factors are associated with high-risk cutaneous-squamous cell carcinoma (cSCC), equivocal definition for high-risk cSCC patients is lacking and their management remains challenging. We aim to identify factors predicting relapse in cSCC patients treated with surgery, combined or not with radiotherapy (RT) and to assess if adjuvant RT was associated with benefits in PFS.
Methods
This retrospective analysis included patients with resectable cSCC treated with surgery and/or RT in curative intent, at Centre Léon Bérard (Lyon, France) from April 2010 to September 2020. Independent predictive factors for relapse were searched using Cox regression analyses. The benefit of adjuvant RT was assessed according to the number of risk factors. PFS was estimated using the Kaplan-Meier method. Lesions were used as statistical units.
Results
A total of 303 patients with 529 cSCC were included. The median number of lesions per patient was 3 (1-25). With a median follow-up of 54 (0.2-126) months, 103 cSCC relapsed. The multivariate analysis identified as predictive factor for relapse in cSCC treated with exclusive surgery, the number of risk factors (HR 15.110 [3.91-58.40] for ≥3 risk factors, HR 4.497 [1.47-13.76] for 1 risk factor, p<0.001), low differentiation (HR 4.930 [2.47-9.86], p<0.001) and perineural involvement (HR 2.442 [1.11-5.38], p=0.027). Deep invasion, location, and tumour size were not significantly associated with higher risk of relapse. 31 cSCC were treated with surgery and adjuvant RT. Considering cSCC with equal number of risk factors, cSCC treated with surgery and adjuvant RT tended to associate with better PFS than cSCC treated with surgery alone (HR 0.47 [0.20-1.14], p=0.087). In the subgroup of cSCC with ≥3 risk factors, a significantly better PFS is observed in cSCC treated with surgery and adjuvant RT compared with those treated with exclusive treatment (p=0.0283).
Conclusions
Increased number of risk factors identified as a predictive factor of relapse in cSCC. Adjuvant RT improved PFS in cSCC with ≥3 risk factors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.