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Karl D. Lewis, MD


Causes of Death in Patients With Cutaneous Squamous Cell Carcinoma: Risk Factors Tell the Story

By: Jenna Carter, PhD
Posted: Friday, September 9, 2022

Although research has shown that non-melanoma skin cancer is the most frequent cancer in White populations, there are limited data on the mortality rates and types of death linked to cutaneous squamous cell carcinoma. Thomas K. Eigentler, MD, of Berlin, and colleagues examined the causes of death in patients with cutaneous squamous cell carcinoma, highlighting both diagnostic and prognostic factors. Their findings, which were published in the European Journal of Cancer, highlighted the three main types of death in this patient population: local infiltration of the tumor, distant metastases, and locoregional metastases.  

A total of 1,400 patients with cutaneous squamous cell carcinoma were included in this study. Cutaneous squamous cell carcinoma–related death and tumor affiliation were verified by localization-dependent attributes, and all tumors were surgically removed and histologically examined. The primary study endpoint was tumor-specific survival, defined as the time from the date of excision to death caused by cutaneous squamous cell carcinoma or to the date of the last observation or to death from causes other than the disease.

Findings revealed that a total of 11 patients died of local tumor infiltration, and 12 patients died of locoregional metastasis in regional lymph nodes; for 10 of the 33 patients who died of cutaneous squamous cell carcinoma, the cause was distant metastasis. Prognostic factors for death from local infiltration included desmoplasia (hazard ratio [HR] = 15.39; P < .01) and bone invasion (HR = 16.9; P < .001), whereas for those whose death was from locoregional metastasis, immunosuppression (HR = 3.27; P < .004) was the sole significant prognostic factor. Additionally, immunosuppression (HR = 4.54; P < .02) was a significant factor in death by distant metastases.

Based on these findings, the study authors concluded that patients with the previously mentioned prognostic factors should be monitored closely.

Disclosure: For full disclosures of the study authors, visit

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