Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip: Implications for treatment modality selection

https://doi.org/10.1016/0190-9622(92)70144-5Get rights and content

We reviewed all studies since 1940 on the prognosis of squamous cell carcinoma (SCC) of the skin and lip. The following variables are correlated with local recurrence and metastatic rates: (1) treatment modality, (2) prior treatment, (3) location, (4) size, (5) depth, (6) histologic differentiation, (7) histologic evidence of perineural involvement, (8) precipitating factors other than ultraviolet light, and (9) host immunosuppression. Local recurrences occur less frequently when SCC is treated by Mohs micrographic surgery. This local recurrence rate differential in favor of Mohs micrographic surgery holds true for primary SCC of the skin and lip (3.1% vs 10.9%), for ear SCC (5.3% vs 18.7%), for locally recurrent (previously treated) SCC (10% vs 23.3%), for SCC with perineural involvement (0% Ys 47%), for SCC of size greater than 2 cm (25.2% vs 41.7%), and for SCC that is poorly differentiated (32.6% vs 53.6%).

References (229)

  • RI Ceilley et al.

    Chemosurgical reports. Malignancies on the external ear: methods of ablation and reconstruction of defects

    J Dermatol Surg Oncol

    (1979)
  • J Conley

    Cancer of the skin of the nose

    Ann Otol

    (1974)
  • H Conway et al.

    Carcinoma of the external ear: analysis of 100 consecutive cases

    Plast Reconstr Surg

    (1957)
  • JR Driver et al.

    Treatment of epithelioma of the skin of the ear

    Am J Roentgenol

    (1942)
  • CF Von Essen

    Roentgen therapy of skin and lip carcinoma. Factors influencing success and failure

    Am J Roentgenol

    (1960)
  • RJ Ferrara

    The private dermatologist and skin cancer: a clinical study of two hundred twenty-six epitheliomas derived from five dermatologic practices

    Arch Dermatol

    (1960)
  • GK Lewis

    Carcinoma of the lip

    J Int Coll Surg

    (1965)
  • JS Lewis

    Cancer of the ear. A report of 150 cases

    Laryngoscope

    (1960)
  • H Martin et al.

    Radiation-induced skin cancer of the head and neck

    Cancer

    (1970)
  • JJ Modlin

    Cancer of the skin: surgical treatment

    Mo Med

    (1954)
  • GT Pack et al.

    Radiation cancer of the skin

    Radiology

    (1965)
  • R Riefkohl et al.

    A rationale for the treatment of difficult basal cell and squamous cell carcinomas of the skin

    Am Plast Surg

    (1985)
  • BF Schreiner et al.

    Results of irradiation treatment of cancer of the lip: analysis of 636 cases from 1926–1936

    Radiology

    (1942)
  • GS Sharp et al.

    Irradiation in cancer of the lip

    JAMA

    (1950)
  • Y Shigematsu et al.

    Results of radiotherapy of skin cancer, with special emphasis on treatment failure

    Radiology

    (1966)
  • TA Tromovitch et al.

    Microscopic-controlled excision of cutaneous tumors: Chemosurgery, fresh tissue technique

    Cancer

    (1978)
  • RG Freeman et al.

    The treatment of skin cancer: a statistical study of 1341 skin tumors comparing results obtained with irradiation, surgery, and curettage followed by electrodesiccation

    Cancer

    (1964)
  • JM Knox et al.

    Curettage and electrodesiccation in the treatment of skin cancer

    Arch Dermatol

    (1960)
  • FE Mohs et al.

    Microscopically controlled surgery in the treatment of carcinoma of the scalp

    Arch Dermatol

    (1981)
  • FE Mohs

    Micrographic surgery for the microscopically controlled excision of eyelid cancers

    Arch Ophthalmol

    (1986)
  • P Robins et al.

    Squamous-cell carcinoma treated by Mohs' surgery: an experience with 414 cases in a period of 15 years

    J Dermatol Surg Oncol

    (1981)
  • G Swanbeck et al.

    Analysis of etiological factors of squamous cell skin cancer of different locations. 1. The lower limbs

    Acta Derm Venereol (Stockh)

    (1969)
  • L Hillstrom et al.

    Analysis of etiological factors of squamous cell skin cancer of different locations. 1. The trunk and the head

    Acta Derm Venereol (Stockh)

    (1970)
  • CS Whelan

    Electrocoagulation the treatment of skin cancers about the head and face

    Surgery

    (1967)
  • CS Whelan et al.

    Electrocoagulation and curettage for carcinoma involving the skin of the face, nose, eyelids, and ears

    Cancer

    (1973)
  • TS Jensen et al.

    Treatment of 433 cases of skin carcinoma with curettage and soft roentgen rays by the Ebbehoj method

    Acta Radiol Ther Phys Biol

    (1973)
  • TS Johnson et al.

    Low-megavoltage electron-beam therapy of head and facial skin cancer using a versatile polystyrene collimator system

    Radiology

    (1975)
  • NP Lang et al.

    Surgical management of advanced scalp cancer

    Head Neck Surg

    (1983)
  • L Molnar et al.

    Carcinoma of the lip: analysis of the material of 25 years

    Oncology

    (1974)
  • JA Del Regato et al.

    Radiotherapy of carcinomas of the skin overlying the cartilages of the nose and ear

    Radiology

    (1962)
  • BP Windmann

    Cancer of the lip

    Am J Roentgenol

    (1950)
  • P Robins et al.

    Analysis of persistent disease on the ear following Mohs surgery

    Head Neck Surg

    (1984)
  • ME Chernosky

    Squamous cell and basal cell carcinomas: preliminary study of 3817 primary skin cancers

    South Med J

    (1978)
  • DE Schuller et al.

    Cutaneous basosquamous carcinoma of the head and neck: a comparative analysis

    Otolaryngol Head Neck Surg

    (1979)
  • H Levine

    Cutaneous carcinoma of the head and neck: management of massive and previously uncontrolled lesions

    Laryngoscope

    (1983)
  • HZ Lund

    How often does squamous cell carcinoma metastasize?

    Arch Dermatol

    (1965)
  • AD Katz et al.

    The frequency and risk of metastases in squamous-cell carcinoma of the skin

    Cancer

    (1957)
  • HZ Lund

    Metastasis from sun-induced squamous-cell carcinoma of the skin: an uncommon event

    J Dermatol Surg Oncol

    (1984)
  • E Epstein et al.

    Metastases from squamous cell carcinomas of the skin

    Arch Dermatol

    (1968)
  • E Epstein

    Malignant sun-induced squamous-cell carcinoma of the skin

    J Dermatol Surg Oncol

    (1983)
  • Cited by (1239)

    • Interest of frozen section procedure in skin tumors other than melanoma

      2023, Journal of Plastic, Reconstructive and Aesthetic Surgery
    View all citing articles on Scopus
    *

    Dr. Rowe is a resident in Dermatology at the University of California at Los Angeles.

    View full text