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Impact of Surgical Delays on Tumor Growth in Patients With Squamous Cell Carcinoma

By: Justine Landin, PhD
Posted: Monday, November 1, 2021

Surgical delays of less than 1 year may lead to tumor growth for patients with poorly and moderately differentiated squamous cell carcinoma, according to Mark A. Russell, MD, of the University of Virginia Health System, Charlottesville, and colleagues. In fact, the retrospective analysis of squamous cell carcinomas indicated that surgical delay led to a growth rate of between 0.24 and 0.28 cm per month. The findings of this study were published in the Journal of the American Academy of Dermatology.

“Our results suggest surgical delays under 11 months in the setting of Mohs micrographic surgery could result in clinically meaningful tumor growth for more aggressive squamous cell carcinomas. This may lead to larger postoperative defects and higher potential for surgical morbidity, recurrence, and metastasis,” stated the study investigators.

Biopsy-proven squamous cell carcinomas (n = 299) and basal cell carcinomas (n = 802) treated with Mohs micrographic surgery at the University of Virginia Health System were analyzed. The time interval to surgery following initial biopsy was considered a surgical delay, and tumor growth was identified as an increase in major diameter from biopsy to postoperative defect. A multivariate analysis was utilized to identify predictors of tumor growth, and linear regression was used to determine whether these predictors were associated with surgical delay.

Histologic subtype (P = .001) and prior treatment (P = .002) were independent predictors for tumor growth in squamous cell carcinomas. Predictors for basal cell carcinoma growth were age, gender, aggressive histology, location, and prior treatment (P = .001 for all). Surgical delays ranged from 0 to 331 days. Surgical delays were significantly associated with increased tumor diameter among poorly (P = .01) and moderately (P = .005) differentiated untreated squamous cell carcinomas, at a rate of 0.24 to 0.28 cm/month, respectively. There was no apparent change in tumor size following surgical delays found for basal cell carcinomas. 

Disclosure: The study authors reported no conflicts of interest.



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