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Oral and Maxillofacial Surgery

Published in:

01-06-2016 | Original Article

Cutaneous squamous cell carcinoma of the scalp in the immunocompromised patient: review of 53 cases

Authors: Sameep Kadakia, Yadranko Ducic, Diego Marra, David Chan, Masoud Saman, Raja Sawhney, Moustafa Mourad

Published in: Oral and Maxillofacial Surgery | Issue 2/2016

Abstract

Objective

We analyzed outcomes from immunocompromised patients with scalp squamous cell carcinoma (SCC) treated with surgical excision with and without radiation in order to explore 3-year disease-free survival and overall survival.

Study design

The study design was a retrospective chart review.

Setting

This study was conducted in a private practice setting.

Subjects and methods

The study included 53 immunocompromised patients with an average age of 63.2 years, with scalp squamous cell carcinoma. Pre-operative imaging dictated the extent of resection. Patients with bony involvement received wide local excision including full-thickness craniectomy and cranioplasty. Patients without bony involvement underwent wide local excision and outer-table calvarial resection. All patients were recommended to have post-operative radiation. Patients were followed for a minimum of 3 years.

Results

A total of 53 patients were included in the study. Six patients had pre-operative CT showing bone involvement and were treated with full-thickness craniectomy along with post-operative radiation. Fourteen patients without bone involvement on pre-operative CT were found to have positive bone involvement on final pathology. Forty-five patients underwent post-operative radiation. Patients treated with adjuvant radiation demonstrated a 3-year survival of 80 % and the overall survival was 62 %. In the surgery-only group, the 3-year survival was 62.5 % and the overall survival was 32.5 %.

Conclusions

Immunocompromised patients with scalp SCC have a poor prognosis. Early detection and treatment are crucial. Based on our results, we recommend wide local excision with at least outer-table calvarial resection, and post-operative radiation. Despite aggressive therapy, patients may still have distant, local, or regional recurrence.

Level of evidence: level 2b (retrospective cohort)

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Title: Cutaneous squamous cell carcinoma of the scalp in the immunocompromised patient: review of 53 cases
Authors: Sameep Kadakia
Yadranko Ducic
Diego Marra
David Chan
Masoud Saman
Raja Sawhney
Moustafa Mourad
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 2/2016
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-016-0545-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cutaneous squamous cell carcinoma of the scalp in the immunocompromised patient: review of 53 cases

Abstract

Objective

Study design

Setting

Subjects and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Study design

Setting

Subjects and methods

Results

Conclusions

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