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Histological deep margins in cutaneous squamous cell carcinoma of the scalp and risk of recurrence

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Verdaguer-Faja, J
  • Guerra-Amor, A
  • Ferrándiz-Pulido, C
  • Masferrer, E
  • Lopez-Castillo, D
  • Deza, G
  • Leal, L
  • Marti-Marti, I
  • Ruiz-Salas, V
  • Yébenes, M
  • Martin, LM
  • Baliu, C
  • Castany, A
  • Boada, A
  • Toll, A
  • Jaka, A

Grupos

Abstract

Background: Consensus is lacking on adequate deep histological margins in cutaneous squamous cell carcinoma (cSCC). Deep clearance for tumours located on the scalp is limited by anatomic constraints. Objective: To determine whether clear but close deep histological margins (<1 mm) confer a higher risk of recurrence in cSCCs of the scalp treated by wide local excision, compared to deep histological margins >= 1 mm. Methods: Multicentre retrospective observational cohort study and multivariate competing risk analysis to evaluate risk factors for recurrence. Results: In total, 295 patients with 338 cSCCs were included. Close deep histological margins were not associated with an increased cumulative incidence of recurrence (subhazard ratio [SHR] 1.96 [95% CI 0.87-4.41]). However, an increased risk of recurrence was observed for those tumours that presented concurrent invasion of the galea aponeurotica and close deep margins, as opposed to patients without these factors (SHR 3.52 [1.24-10.01]). Tumours with clear but close peripheral margins (<1 mm) also had higher risk of recurrence (SHR 5.01 [1.68-14.97]). Limitations: Retrospective observational study based on pathology reports. Conclusion: Deep histological margins <1 mm do not confer a greater risk of recurrence as long as the tumour is completely excised and the galea aponeurotica is not involved. Surgical excision of cSCC on the scalp should include the galea to ensure proper assessment of deep margins.

© 2024 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Datos de la publicación

ISSN/ISSNe:
0926-9959, 1468-3083

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY  WILEY

Tipo:
Article
Páginas:
855-864
PubMed:
39036869
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,613 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 5

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Keywords

  • Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Male; Margins of Excision; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Risk Factors; Scalp; Skin Neoplasms; adjuvant radiotherapy; aged; Article; cohort analysis; cutaneous squamous cell carcinoma of the scalp; deep histological margin; female; galea aponeurotica; histology; histopathology; human; human tissue; immunocompromised patient; lymph vessel metastasis; major clinical study; male; multicenter study; observational study; perineural invasion; recurrence risk; retrospective study; risk factor; squamous cell skin carcinoma; tumor invasion; visceral metastasis; clinical trial; epidemiology; head and neck tumor; middle aged; pathology; scalp; skin tumor; squamous cell carcinoma; surgery; surgical margin; tumor recurrence; very elderly

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