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Patterns of Major Surgery for Cutaneous Squamous Cell Carcinoma

By: Susan Reckling
Posted: Tuesday, July 23, 2019

To better understand the role of major surgery among patients with cutaneous squamous cell carcinoma, particularly those who required systemic therapy, Emily S. Ruiz, MD, MPH, of Brigham and Women’s Hospital, Harvard Medical School, Boston, and colleagues conducted a study based on Truven MarketScan claims data. They found that over a 2-year period, one in five patients underwent at least one major operation. In addition, systemic therapy did not seem to substantially diminish the risk of major surgery. These findings were published in conjunction with the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting (online Abstract e21034) and in the Journal of Clinical Oncology.

“For patients who received systemic therapy, the 1-year and 2-year risk of major surgery was higher for immunocompromised patients compared to immunocompetent patients,” the investigators added.

From the study data obtained, patients’ first diagnosis of cutaneous squamous cell carcinoma was identified as between 2013 and 2018. The major operations consisted of facial excision of more than 3.1 cm, parotidectomy, removal of ear/eye/nose, amputations, craniectomy, excision of extracranial nerves, sentinel lymph node biopsy, lymphadenectomy, complex repair (> 7.5 cm), integra, free flaps, and large grafts of more than 20 sq cm. Of the 240,122 patients identified with cutaneous squamous cell carcinoma, the mean age was 67.7 years, and more than half (56.5%) were men.

The investigators found that the risk of major surgery at 1 year was 15.1 and at 2 years, it was 18.6%. A total of 782 patients received either prior or concurrent systemic therapy, with 22.4% being immunocompromised. “Among those who received systemic therapy, 1- and 2-year risks were 8.4% and 14.2% for immunocompetent and 14.1% and 19.3% for immunocompromised patients, respectively,” they reported.

Disclosure: The study authors’ disclosure information may be found at coi.asco.org.



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