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Risk Factors for Recurrence and Metastasis in Squamous Cell Carcinoma of the Skin

Description

While often considered relatively innocuous tumors, squamous cell carcinomas of the skin may be serious tumors that can recur and metastasize. Certain risk factors can help identify those patients at greater risk for an aggressive course.


 

 

Lesional Parameters

Relative Risk to Recur

Relative Risk to Metastasize

rapid growth rate

I

I

size > 2 cm

2

2

located on lip or ear

2

3

located on scalp, forehead, temple, eyelid, nose, mucous membranes, dorsum of hands, penis, scrotum, anus

I

I

located in an area of chronic injury

??

I

 

 

Other Parameters

Relative Risk to Recur

Relative Risk to Metastasize

immunosuppression

I

2

history of treatment for squamous cell carcinoma

3

4

history of radiation treatment

I

I

 

 

Histological Parameters

Relative Risk to Recur

Relative Risk to Metastasize

poorly differentiated histology

2

3

spindle cell histology

I

I

acantholytic features

I

I

infiltrative margins (deep or radial)

I

I

tumor depth > 4 mm or to Clark level IV or V

2

5

perineural invasion

5

5

 

where:

• The relative risk is compared to a small primary squamous cell carcinoma of the skin.

• "I" indicates increased risk but relative risk uncertain.

• Clark level IV indicates involvement of the reticular dermis.

• Clark level V indicates involvement of the subcutaneous fat.

 


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