(HealthDay News) — The risks of metastasis and death associated with cutaneous squamous cell carcinoma (CSCC) are low, but significant, and risk factors for poor outcome include tumor diameter, invasion beyond fat, poor differentiation, and location, according to a study published in the May issue of JAMA Dermatology.

To identify risk factors associated with poor outcomes in primary CSCC, Chrysalyne D. Schmults, M.D., from Brigham and Women’s Hospital in Boston, and colleagues retrospectively analyzed CSCC outcomes for 985 patients with 1,832 tumors.

The researchers found that over a median follow-up of 50 months, local recurrence occurred in 4.6% of patients, 3.7% developed nodal metastases, and 2.1% died of CSCC. Independent predictors for nodal metastasis and disease-specific death included a tumor diameter of at least 2 cm (subhazard ratios, 7.0 and 15.9, respectively), poor differentiation (6.1 and 6.7), invasion beyond fat (9.3 and 13.0), and ear or temple location (3.8 and 5.9), according to multivariate competing risk analyses. Disease-specific death was associated with perineural invasion (subhazard ratio, 3.6) and anogenital location, but few cases were anogenital. Poor differentiation (subhazard ratio, 1.3) and invasion beyond fat (1.7) correlated with overall death.

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“Cutaneous squamous cell carcinoma carries a low but significant risk of metastasis and death,” write the authors. “Accurate risk estimation of outcomes from population-based data and clinical trials proving the utility of disease-staging modalities and adjuvant therapy is needed.”

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