Tokez Selin, Wakkee Marlies, Kan Wilner, Venables Zoe C, Mooyaart Antien L, Louwman Marieke, Nijsten Tamar, Hollestein Loes M
Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom; Public Health England, Fulbourn, Cambridgeshire, United Kingdom.
J Am Acad Dermatol. 2022 Feb;86(2):331-338. doi: 10.1016/j.jaad.2021.09.067. Epub 2021 Oct 13.
Cutaneous squamous cell carcinoma (cSCC) represents the most serious form of keratinocyte cancers because of its metastatic potential. Studies on nationwide incidence and disease-specific survival rates of metastatic cSCC (mcSCC) are lacking.
To investigate the cumulative incidence and disease-specific survival of patients with mcSCC in the Dutch population and assess patient-based risk factors.
We conducted a nationwide cancer registry study including all patients with the first cSCC in 2007 or 2008, using data from the Netherlands Cancer Registry, the nationwide network and registry of histopathology and cytopathology, and Statistics Netherlands. Cumulative incidence and Kaplan-Meier curves were calculated, and time-dependent Cox proportional hazards regression analyses were used.
Of the 11,137 patients, metastases developed in 1.9% (n = 217). The median time to metastasis was 1.5 years (interquartile range 0.6-3.8 years). The risk factors were age (adjusted hazard ratio [aHR] 1.03, 95% CI 1.02-1.05), male sex (aHR 1.7, 95% CI 1.3-2.3), and immunosuppression (aHR [organ transplant recipient] 5.0, 95% CI 2.5-10.0; aHR [hematologic malignancy] 2.7, 95% CI 1.6-4.6). The 5-year disease-specific survival for patients with mcSCC was 79.1%.
Only histopathologically confirmed mcSCCs were included.
About 2% of cSCCs metastasize, with higher risk for men, increasing age, and immunocompromised patients. Disease-specific survival for patients with mcSCC is high.
皮肤鳞状细胞癌（cSCC）因其转移潜能而成为最严重的角质形成细胞癌形式。目前缺乏关于转移性cSCC（mcSCC）的全国发病率和疾病特异性生存率的研究。
调查荷兰人群中mcSCC患者的累积发病率和疾病特异性生存率，并评估基于患者的风险因素。
我们进行了一项全国性癌症登记研究，纳入了2007年或2008年首次诊断为cSCC的所有患者，使用了荷兰癌症登记处、全国组织病理学和细胞病理学网络及登记处以及荷兰统计局的数据。计算累积发病率和Kaplan-Meier曲线，并进行时间依赖性Cox比例风险回归分析。
在11137例患者中，1.9%（n = 217）发生了转移。转移的中位时间为1.5年（四分位间距0.6 - 3.8年）。风险因素包括年龄（调整后风险比[aHR] 1.03，95%置信区间1.02 - 1.05）、男性（aHR 1.7，95%置信区间1.3 - 2.3）和免疫抑制（aHR[器官移植受者] 5.0，95%置信区间2.5 - 10.0；aHR[血液系统恶性肿瘤] 2.7，95%置信区间1.6 - 4.6）。mcSCC患者的5年疾病特异性生存率为79.1%。
仅纳入了组织病理学确诊的mcSCC。
约2%的cSCC会发生转移，男性、年龄增长和免疫功能低下患者的转移风险更高。mcSCC患者的疾病特异性生存率较高。
