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Karl D. Lewis, MD


Metastatic Cutaneous Squamous Cell Carcinoma in the Netherlands

By: Gavin Calabretta, BS
Posted: Monday, April 11, 2022

Cutaneous squamous cell carcinoma is the second-most common cancer worldwide, and metastasis occurs in an estimated 1.5% to 5.2% of patients. With the goal of closely examining disease incidence and survival outcomes, Loes M. Hollestein, PhD, of Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues performed a nationwide population-based study on data obtained from several cancer directories, including the Netherlands Cancer Registry. The study, published in the Journal of the American Academy of Dermatology, identified several distinct risk factors that were associated with metastasis.

“Due to high incidence rates, it has been estimated that [cutaneous squamous cell carcinoma] accounted for similar death rates as various other cancers, including melanoma and leukemia,” the study authors commented. “The aim of this study was to determine the Dutch cumulative incidence of [metastatic cutaneous squamous cell carcinoma] and describe disease-specific survival rates, stratified by patients’ immune status.”

In addition to the Netherlands Cancer Registry, the study authors also utilized data from the nationwide network and registry of histopathology and cytopathology and Statistics Netherlands. Patient characteristics, including organ transplants, hematologic malignancies, metastasis location, sex, and age, were included in the 11,137-patient analysis.

In total, 217 metastases were discovered and included in the study. Reportedly, 74% of metastases arose from the primary disease site, and 26% arose from subsequent locations. However, in organ transplant recipients, 89% came from the primary site, and in patients with hematologic malignancies, 63% came from the first location. The overall cumulative incidence of metastatic disease was 1.9% (95% confidence interval [CI] = 1.8%–2.0%), with a median time to metastasis of 1.5 years (interquartile range, 0.6–3.8 years) and a 5-year disease-specific survival of 79.1%. Additionally, metastatic risk factors included age, male sex, and immunosuppression.

Disclosure: For full disclosures of the study authors, visit

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