Clinicopathological Factors Associated with Incomplete Excision of Cutaneous Squamous Cell Carcinoma
Helena Svensson, John Paoli
Cutaneous squamous cell carcinoma (SCC) is the second most common type of cancer in Swedish men and women. The incidence of SCC is increasing rapidly. Primary treatment is complete surgical excision with sufficient margins to avoid recurrence and metastasis. The aim of this retrospective study was to identify the clinicopathological factors associated with incomplete excision of SCCs. Clinicopathological data and surgical outcome was obtained for 691 SCCs excised during a 2-year period (2014 to 2015) in Gothenberg, Sweden. Overall, 81 SCCs (11.7%) were incompletely excised. Incomplete excisions were associated with physician specialty and experience, tumour localization in the head and neck region, larger tumour diameter, and lower grade of tumour differentiation. However, multiple regression analysis revealed that large tumour size and excisions carried out by general practitioners were the only factors that significantly negatively affected rates of incomplete excision. These results should be taken into consideration when excising SCCs, in order to avoid multiple excisions.
Cutaneous squamous cell carcinoma is one of the most common skin cancers and its incidence is increasing in many parts of the world, including Sweden. The main treatment is surgical excision with the goal of complete removal, in order to avoid local recurrence as well as metastatic disease. This study found that the 2 most important risk factors for incomplete excision were: excisions carried out by general practitioners and large tumour size. Therefore, general practitioners need further support in managing patients with squamous cell carcinoma, and surgeons should be aware of the difficulties in removing larger tumours.