Surgical delays of less than 1 year in Mohs surgery associated with tumor growth in moderately- and poorly-differentiated squamous cell carcinomas but not lower-grade squamous cell carcinomas or basal cell carcinomas: A retrospective analysis

Evidence is controversial and limited concerning whether surgical delays are associated with tumor growth for cutaneous squamous cell carcinomas (SCCs) and basal cell carcinomas. Identify tumor subpopulations that may demonstrate an association between tumor growth and surgical delay. We retrospecti...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2022-01, Vol.86 (1), p.131-139
Main Authors: Lee, Jack, Forrester, Vernon J., Novicoff, Wendy M., Guffey, Darren J., Russell, Mark A.
Format: Article
Language:English
Subjects:
basal cell carcinoma
Carcinoma, Basal Cell - pathology
Carcinoma, Basal Cell - surgery
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
growth rate
Humans
lesion size
Mohs Surgery
nonmelanoma skin cancer
Retrospective Studies
skin cancer
Skin Neoplasms - pathology
Skin Neoplasms - surgery
squamous cell carcinoma
surgical delay
tumor growth
tumor size
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Summary:Evidence is controversial and limited concerning whether surgical delays are associated with tumor growth for cutaneous squamous cell carcinomas (SCCs) and basal cell carcinomas. Identify tumor subpopulations that may demonstrate an association between tumor growth and surgical delay. We retrospectively analyzed 299 SCCs and 802 basal cell carcinomas treated with Mohs surgery at a single institution. Time interval from biopsy to surgery represented surgical delay. Change in major diameter (ΔMD) from size at biopsy to postoperative defect represented tumor growth. Independent predictors of ΔMD were identified by multivariate analysis. Linear regression was then utilized to assess for whether the ΔMD from these independent predictors trended with surgical delay. Surgical delays ranged from 0 to 331 days. Among SCCs, histologic subtype and prior treatment were identified as independent predictors of ΔMD. Significant associations between ΔMD and surgical delay were found for poorly- and moderately-differentiated SCCs, demonstrating growth rates of 0.28 cm and 0.24 cm per month of delay, respectively. The ΔMD for SCCs with prior treatment and basal cell carcinoma subgroups did not vary with surgical delay. Retrospective design, single center. Surgical delays of less than a year were associated with tumor growth for higher-grade SCCs, with effect sizes bearing potential for clinical significance.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2021.08.059