Postoperative Radiotherapy for Residual Disease in Cutaneous Squamous Cell Carcinoma
Posted: Wednesday, February 24, 2021
The results of a study published as a research letter in JAMA Dermatology suggest that postoperative radiotherapy after incomplete excision in patients with primary head and neck cutaneous squamous cell carcinoma may be an effective treatment option if re-excision of the tumor is not preferable. The disease progression rate in this larger cohort of 66 patients by Emöke Rácz, MD, PhD, of the University of Groningen, the Netherlands, and colleagues was 19.7%—much lower than reported in another small study of patients.
“A possible explanation is that the cohort in the present study contained more low-stage tumors,” stated the authors. “Additional comparative studies are necessary to determine the value of postoperative radiotherapy compared with re-excision or watchful waiting.”
This retrospective study included 66 patients with primary head and neck cutaneous squamous cell carcinoma treated between 2000 and 2014 with postoperative radiotherapy after incomplete excision with microscopic residual disease. The median follow-up was 45.5 months.
In all, 13 patients (19.7%) developed disease progression, most of whom had advanced-stage tumors. This included seven patients with more than one type of disease progression; nine developed local recurrences within the field of radiation, eight developed nodal metastasis, and six died of cutaneous squamous cell carcinoma.
The median time until disease progression was 15 months, and the median disease-free survival in the total group was 44 months. In patients with T1 tumors, 17.4% developed progression of disease compared with 25% of patients with T3 tumors; periocular tumors, poor differentiation, and extradermal invasion were more common in those who experienced disease progression.
Disclosure: The authors reported no conflicts of interest.
