Why does squamous cell carcinoma reoccur

Some patients abandoned treatment because of personal reasons. Ninety Recurrence time ranged from 2 to 96 months, with a median time of 14 months. The tumor recurred in the neck in 45 patients, at the primary tumor site in 36 patients, and at both the primary site and neck in 9 patients. We performed univariate analysis between various clinicopathologic factors and OSCC recurrence.

Seventy-two patients died due to tumor-related diseases, and 90 had recurrence. The 5-year overall survival rate was The survival time ranged from 6 to months, with a median of 36 months. The Kaplan-Meier method and log-rank test showed that the 2- and 5-year survival rates were lower in patients with recurrence than in those without recurrence The 2- and 5-year survival rates were lower in the recurrence group than in the non-recurrence group In this study, 90 Factors that influence the recurrence of OSCC have been extensively explored in recent years.

Ebrahimi et al. They have concluded that tongue cancer and poor differentiation contributed to OSCC recurrence after surgery. Statistical analysis showed that co-morbidities, degree of tumor differentiation, and tumor stage were important prognostic factors for recurrence.

In our study, the recurrence rate was In the studies by Camisasca et al. Therefore, the lower recurrence rate in our study may be due to the following conditions: 1 preoperative cycles of TPF neoadjuvant chemotherapy, 2 patients at advanced stages underwent postoperative cycles of adjuvant chemotherapy or radiotherapy, or 3 complete tumor resection achieved with the help of various flaps.

Therefore, we believe that T3-T4 stage, poor tumor differentiation, and pN positivity are important factors for the recurrence of OSCC. In addition, flap repair, adjuvant chemotherapy, or radiotherapy may also reduce recurrence.

Identifying relevant factors of tumor recurrence can help establish treatment standards. Surgery remains the preferred treatment for OSCC. However, for patients at T3-T4 stages and with poorly differentiated tumors, primary tumor resection margin should be expanded, generally 2 cm or more from the tumor, to ensure surgical safety.

Flap repair should also be performed. Our results showed that the application of flap repair significantly reduced local tumor recurrence. They found that the mortality was Therefore, the application of free flap repair can improve the 5-year survival rate of patients.

In addition, neck lymph nodes should be carefully cleaned while resecting the primary tumor. For patients with cN0 diseases, lymph nodes in the ipsilateral neck I-III regions should be selectively cleaned.

Capote et al. They found that the regional recurrence rate was significantly lower in patients who underwent selective neck lymph node dissection than in those who underwent primary tumor resection only. Thus, neck lymph node dissection is an important prognostic factor for the recurrence of OSCC. For neck lymph node-positive patients, radical neck dissection should be performed in the ipsilateral carotid I-V region.

Preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy or radiotherapy can also reduce recurrence and improve prognosis. All patients in this study underwent cycles of preoperative neoadjuvant chemotherapy, and patients in advanced stages were treated with 4 cycles of adjuvant chemotherapy or radiotherapy after surgery. Cooper et al. In this study, we explored clinicopathologic factors of recurrence in OSCC and discussed some perspectives for clinical reference.

In recent years, the expression of certain genes has been reported to closely relate to the recurrence of OSCC. Cheng et al. Liu et al. Therefore, our future work will explore mechanisms of OSCC recurrence at the molecular level to develop better treatment strategies. National Center for Biotechnology Information , U.

Journal List Chin J Cancer v. High-risk spinocellular tumours measure more than 2 cm, present on the face, are histologically invasive if thicker than 2 mm with a Clark level greater than iv , involve perineural invasion and are poorly differentiated. In situ squamous cell carcinoma is limited to the epidermis and is the precursor to invasive squamous cell carcinoma, which must be treated aggressively and accurately to prevent its progression and worsen the patient's prognosis.

There are many studies on the effectiveness of MMS and the low incidence of recurrence, some with insufficient evidence to compare effectiveness and the different treatments used for SCC. This prompted Dr Chren to analyse 2 university sites with a population of patients and tumours treated with different methods, including excision and MMS. It must be stressed that in our study, despite having tumours with high-risk factors for recurrence, a recurrence rate of 2.

This finding is important, since it offers us the opportunity to provide optimal treatment for cutaneous squamous cell carcinoma at lower cost and in areas that lack the infrastructure to perform the aforementioned surgical technique. Surgical defect after SCC excision with margin, left open until the histopathological report. When this returns tumour-free, the wound will be closed. We must emphasise that one of the cases that recurred was an in situ squamous cell carcinoma, which was treated with the surgical margin indicated in the clinical guidelines.

This leads us to the conclusion that it is likely that, rather than a recurrence, this was a new cancer in an area of field cancerisation with extensive photodamage. The other 3 tumours that recurred were invasive and of an aggressive histological type, which is a very important risk factor for recurrence and metastasis. We must suspect recurrence if a skin lesion appears on the scar or an area nearby; it can present as an erythemato-squamous plaque or a tumour ranging from millimetres to centimetres in size.

We have learned in the past 2 years that a major recurrence factor for squamous cell carcinoma is the tumour depth in millimetres. Because this is a ten-year retrospective study, we do not have this data for all the tumours we studied, since in previous years this feature was not routinely assessed.

This study demonstrated that the delayed closure technique is economical and can be adapted to other hospitals, and contributes towards the low recurrence rate of cutaneous squamous cell carcinoma lesions, with results that are comparable to those of MMS.

The authors declare that no experiments were performed on humans or animals for this study. The authors declare that they have followed the protocols of their work centre on the publication of patient data. The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document. The authors have no conflict of interests to declare. Cir Cir. ISSN: Follow us:. Previous article Next article.

Issue 6. Pages November - December More article options. Characteristics and risk factors for recurrence of cutaneous squamous cell carcinoma with conventional surgery and surgery with delayed intraoperative margin assessment.

Download PDF. Corresponding author. This item has received. Under a Creative Commons license. Article information. Table 1. General characteristics of squamous cell carcinoma in the sample studied.. Background Non-melanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma SCC.

SCC has a more aggressive behaviour invading first the skin, the lymph nodes and less frequently produces distance metastasis. Objective To identify the characteristics of recurrent SCC and frequency of new SCC after conventional surgical and primary closure or closure delayed until a histological reporting of tumour-free surgical margins, in order to achieve a better surgical option, in our Mexican population.

Materials and method We reviewed clinical records from the last 10 years, and included those with a diagnosis of SCC. Results One hundred and fourteen tumours in patients were included. At year follow-up we found a second SCC in 14 patients and only 4 recurrences, between the 1st and 4th year and 3 were treated with delayed closure until margins were tumour-free. Conclusion In this study we demonstrated that delayed closure technique is easy and adaptable in our population in the treatment of SCC, achieving good results with very low recurrences at year follow-up.

Non-melanoma skin cancer. Antecedentes El carcinoma de piel no melanoma basocelular y el carcinoma epidermoide o espinocelular CEC son tumores frecuentes. Resultados Se incluyeron tumores en pacientes.

Palabras clave:. Full Text. Background Non-melanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma. Objective To identify the characteristics of squamous cell carcinoma, its recurrence and the frequency of onset of new tumours, in our cases, and to identify those treated surgically with direct closure or closure delayed until receiving a tumour-free margin report delayed closure , and thus determines optimal treatment behaviours.

Material and method The clinical records of patients diagnosed with squamous cell carcinoma who attended the dermatological surgery department of the Hospital General Dr. Results One hundred and fourteen tumours were studied, from patients with a diagnosis of squamous cell carcinoma.

Figure 1. Figure 2. Leibovitch, S. Huilgol, D. Selva, S. These include:. The oncologists and other medical professionals in the Cutaneous Oncology Program at Moffitt Cancer Center understand that the possibility of recurrence is a concern of many former skin cancer patients. To help provide peace of mind for survivors and at-risk individuals, we can provide lifelong dermatologic surveillance that incorporates the latest techniques for skin examination and biopsy.

Our patients can also benefit from our support groups and supportive care services, such as yoga and massage, which can help relieve stress and promote general well-being.

If you are concerned about a squamous cell carcinoma recurrence, the experts at Moffitt can provide individualized advice and preventive strategies to help reduce your risk, along with advanced diagnostic tests to ensure early detection and prompt treatment. Call or complete a new patient registration form online. We see patients with and without referrals. Please call for support from a Moffitt representative. New Patients and Healthcare Professionals can submit an online form by selecting the appropriate buttonbelow.

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