Early invasive squamous cell carcinoma recurrence rates: A study examining surgical margins, tumor surface diameter, invasion depth, and grade of differentiation in 1296 cases over 9 years

Background Invasive squamous cell carcinoma (SCC) is typically treated by surgical excision. Methods Consecutive SCC excisions were reviewed prospectively in a single Australian center from 2009 to 2017. Cases were examined for recurrence by histopathologic margins, microscopic tumor surface diamete...

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Bibliographic Details
Published in:Journal of cutaneous pathology 2019-02, Vol.46 (2), p.111-116
Main Authors: Pyne, John H., Myint, Esther, Clark, Simon P., Barr, Elizabeth M., Hou, Ruihang
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Ear
Female
grade of differentiation
Humans
invasion depth
invasive squamous cell carcinoma
Invasiveness
Lip
Male
Neoplasm Invasiveness
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
recurrence rates
Retrospective Studies
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Squamous cell carcinoma
surgical margins
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Summary:Background Invasive squamous cell carcinoma (SCC) is typically treated by surgical excision. Methods Consecutive SCC excisions were reviewed prospectively in a single Australian center from 2009 to 2017. Cases were examined for recurrence by histopathologic margins, microscopic tumor surface diameter, invasion depth, grade of differentiation, and anatomic site. Results Over 9 years, 1296 cases were collected. By grade of differentiation maximum average microscopic surface diameters ranged from 8.0 to 9.6 mm and maximum average depths from 1.3 to 2.5 mm. Minimum average histopathologic margins for well, moderate, and poorly differentiated SCC, respectively, were 1.4, 1.1, and 1.3 mm. Recurrence occurred in 1.7% of well (n = 18/1084), 1.8% moderate (n = 3/165) and 6.4% in poorly differentiated (n = 3/47) SCC. No recurrence occurred beyond a histopathologic margin of 3.5 mm for well and 2.5 mm for moderately differentiated SCC. Highest recurrence for well‐differentiated SCC by anatomic site was the lip (7.0%) then ear (4.6%). Conclusion We found a recurrence rate of 1.0% for histopathologic margins of 1.5 mm with early well‐differentiated SCC. The grade of differentiation and anatomic site had a larger influence on recurrence rates compared to the histopathologic margins. Poorly differentiated SCC and ear or lip sites require wider surgical margins.
ISSN:0303-6987
1600-0560
DOI:10.1111/cup.13392