Not Your Garden Variety Skin Cancer

Cutaneous squamous cell carcinoma can metastasize and cause death

May 15, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Skin cancers that are not melanoma are typically curable. A common type of skin cancer, though, can spread and become lethal, new research has found.

Five risk factors, including tumor size and location, tend to forecast a more serious course for cutaneous squamous cell carcinoma (CSCC), according to the new research.

"If you see a change in a mole, visit a dermatologist."

CSCC is diagnosed in about 250,000 Americans each year and accounts for about 20 percent of skin cancer cases. While the sun causes most of these cancers, CSCC can also be caused by burns, chemicals or x-ray exposure.

The disease is treated – and usually cured - with surgery to remove the tumors.

Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues conducted a 10-year study involving 985 patients diagnosed with CSCC and 1,832 tumors.

The researchers were looking at the outcomes of CSCC, specifically patterns of return (recurrence), metastasis (spread) to the lymph nodes and number of deaths related to the cancer.

Participants were followed for a median of 50 months.

During the study period, 45 individuals (4.6 percent) saw the cancer recur, 36 (3.7 percent) had lymph node metastasis and 21 people (2.1 percent) died of CSCC.

The scientists found five factors influenced a poor course/outcome. These factors included a tumor of 2 centimeters or more, poor differentiation (difficulty telling cancer cells from normal cells), spread beyond fat, and location on the ear or temple.

Additionally, tumors that spread to the space surrounding a nerve or were located near the anus or genitalia, were more likely to be life-threatening.

“These 5 risk factors may be among the most significant drivers of CSCC outcomes, but further studies are needed to replicate our findings” the authors concluded.

Susan Chon, MD, associate professor of dermatology at The University of Texas MD Anderson Cancer Center, told dailyRx News, “Although squamous cell carcinoma (SCC) is not as lethal as melanoma, dermatologists take them seriously. We know they have a low risk of metastasizing but we do follow up patients closely who have a history of SCC. This can also include a regional lymph node exam.

“The factors mentioned in this study are often available in the initial evaluation and pathology report. Patients with any of these factors should be followed closely for possible development of metastatic disease,” Dr. Chon said.

This study was published May 15 in JAMA Dermatology. No funding information was provided, and no conflicts of interest were disclosed.

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Review Date: 
May 15, 2013
Last Updated:
August 13, 2013