Abstract

VASQUEZ, M et al. High-risk invasive cutaneous squamous cell carcinoma: use of current classification. Rev. argent. dermatol. [online]. 2017, vol.98, n.3. ISSN 1851-300X.

Introduction: high-risk cutaneous squamous cell carcinoma is defined as one that has a risk of recurrence and lymph node metastasis and / or distance greater than 5%, due to this, it is preponderant knowledge of the factors that make it a high tumor risk, to achieve their identification and thus carry out the appropriate treatment and follow-up. Objectives: to estimate the prevalence of cutaneous squamous cell carcinoma (CSC) in patients attending the outpatient clinic of the Hospital Privado Universitario de Córdoba and Hospital Raúl Ferreyra in Córdoba, Argentina from July 2014 to December 2015. To calculate the prevalence of invasive squamous cell carcinoma; to describe the epidemiological, clinical and histopathological characteristics of high risk of invasive SCC; to determine the percentage of patients with high-risk CSC according to the AJCC classification. Determine the percentage of high-risk CSC according to the classification proposed by the NCCN and to compare the percentages of patients with invasive high-risk CSC, which were obtained by applying the current AJCC and NCCN assessment systems. Materials and Methods: we performed a retrospective descriptive study with direct collection of information from the histopathology report, included in the database of the pathology file of the Hospital Universitario de Córdoba, with subsequent review of clinical records of each of the patients included and a token designed for this purpose was completed. With the data obtained excel sheets were completed; Breslow, Clark and others were included in the study, including: sex, age at diagnosis, history of immunosuppression, sites of chronic inflammation, And perineural invasion. The data obtained were submitted to each of the classifications: AJCC 2010, and NCCN 2013. Results: the prevalence of squamous cell carcinoma in our population was 0.24%, and the prevalence of invasive CEC with respect to cutaneous ECC is of 59%. In our population of 78 patients 100% were caucasian argentines, we found that the median age was 75,5 years, the range of patients between 61 and 90 years were the most affected including 80.7 % from the patients. Regarding sex, most of the patients were men 49 (63%), and the most affected location was head and neck with 57 (68%). In our cohort, we obtained 34 (40%) tumors that were classified as T2 (high risk) according to the AJCC criteria, while the majority (74%) were "high risk" according to the guidelines of the NCCN. Conclusions: the purpose of the AJCC staging system is different from the NCCN treatment guidelines. The purpose of the AJCC staging system is to stratify patients with similar group scores to provide accurate prognostic estimates, while the NCCN guidelines are intended to guide the management, treatment, and follow-up of CSC. Therefore, that each one has its defined objectives, and must be used according to the use that we intend to give it.

Keywords : high risk squamous cell carcinoma; metastases; classifications.