Histological deep margins in cutaneous squamous cell carcinoma of the scalp and risk of recurrence
Background: Consensus is lacking on adequate deep histological margins in cutaneous squamous cell carcinoma (cSCC). Deep clearance for tumours located on the scalp is limited by anatomic constraints. Objective: To determine whether clear but close deep histological margins (<1 mm) confer a higher...
| Autores: | , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p5006 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/5006 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85199098109&doi=10.1111%2fjdv.20250&partnerID=40&md5=db26f28050d22cb5c1639d27f47cd6a6 |
| Access Level: | acceso abierto |
| Palabra clave: | adjuvant radiotherapy aged Article cohort analysis cutaneous squamous cell carcinoma of the scalp deep histological margin female galea aponeurotica histology histopathology human human tissue immunocompromised patient lymph vessel metastasis major clinical study male multicenter study observational study perineural invasion recurrence risk retrospective study risk factor squamous cell skin carcinoma tumor invasion visceral metastasis clinical trial epidemiology head and neck tumor middle aged pathology scalp skin tumor squamous cell carcinoma surgery surgical margin tumor recurrence very elderly Aged Aged, 80 and over Carcinoma, Squamous Cell Female Head and Neck Neoplasms Humans Male Margins of Excision Middle Aged Neoplasm Recurrence, Local Retrospective Studies Risk Factors Scalp Skin Neoplasms |
| Sumario: | Background: Consensus is lacking on adequate deep histological margins in cutaneous squamous cell carcinoma (cSCC). Deep clearance for tumours located on the scalp is limited by anatomic constraints. Objective: To determine whether clear but close deep histological margins (<1 mm) confer a higher risk of recurrence in cSCCs of the scalp treated by wide local excision, compared to deep histological margins >= 1 mm. Methods: Multicentre retrospective observational cohort study and multivariate competing risk analysis to evaluate risk factors for recurrence. Results: In total, 295 patients with 338 cSCCs were included. Close deep histological margins were not associated with an increased cumulative incidence of recurrence (subhazard ratio [SHR] 1.96 [95% CI 0.87-4.41]). However, an increased risk of recurrence was observed for those tumours that presented concurrent invasion of the galea aponeurotica and close deep margins, as opposed to patients without these factors (SHR 3.52 [1.24-10.01]). Tumours with clear but close peripheral margins (<1 mm) also had higher risk of recurrence (SHR 5.01 [1.68-14.97]). Limitations: Retrospective observational study based on pathology reports. Conclusion: Deep histological margins <1 mm do not confer a greater risk of recurrence as long as the tumour is completely excised and the galea aponeurotica is not involved. Surgical excision of cSCC on the scalp should include the galea to ensure proper assessment of deep margins. |
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