Cutaneous Squamous-Cell Carcinoma: A Full Review

One in five Americans will have skin cancer in their lifetime. Nonmelanoma skin cancers, or keratinocyte carcinomas, are the most common type of cancer treated in the U.S., with 5 million+ incident cases per year.

Full Review Article: https://t.co/LmxTLfcoJT 1/14#oncology

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Cutaneous squamous-cell carcinoma is the second most common type of skin cancer, with more than 1 million new cases per year, outnumbering all top five reportable cancers treated in the United States combined. 2/14

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The overall prognosis for patients with cutaneous squamous-cell carcinoma is excellent. Nodal metastases develop in 1.9 to 5.2% of cases, and overall mortality is 1.5 to 3.4%. However, patients with metastases tend to have much poorer outcomes. 3/14

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Among immunosuppressed patients, the risk of cutaneous squamous-cell carcinoma is increased by a factor of 65 to 250, with a higher incidence of local recurrence and metastasis in 6 to 15% of cases. 4/14

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Cutaneous squamous-cell carcinoma accounts for an increasing number of deaths from skin cancer in the U.S., with estimates suggesting that the absolute numbers of patients with nodal metastasis and of deaths are equal to or exceed those for melanoma or leukemia. 5/14

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Both the incidence of cutaneous squamous-cell carcinoma and the burden of disease are on the rise. 6/14

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Cutaneous squamous-cell carcinoma can develop on any surface of the skin. It is more common in men than in women, and the risk increases dramatically with age. The incidence among persons older than 75 years of age is 5x–10x that among those younger than 55 years of age. 7/14

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Patients typically present with scaly, erythematous, or bleeding lesions, most often on sun-exposed areas, and the appearance of these lesions differs according to histologic subtype. 8/14 pic.twitter.com/DzazAPMMEz

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Staging of this cancer has changed dramatically in the past 10 years, with several refinements integrating clinical and pathological risk factors for local recurrence and metastasis to improve risk stratification, distinctiveness between tumor stages, and monotonicity. 9/14

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Individual clinical and pathological factors associated with increased rates of local recurrence and metastasis are shown in the figure below. 10/14 pic.twitter.com/fsvymmOXLg

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Squamous-cell carcinoma, with more than 1 million new cases annually and mortality now exceeding that for melanoma, represents a major health care burden. 11/14

— NEJM (@NEJM) June 20, 2023

The incidence, associated mortality, and economic impact of cutaneous squamous-cell carcinoma will continue to increase with the aging population and rising incidence of exogenous immunosuppression. 12/14

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Future directions include the development of prognostic nomograms with patient-specific factors, a greater understanding of clinicopathological features and tumor biology, and the identification of new tumor biomarkers to help predict metastasis and poor outcomes. 13/14 pic.twitter.com/4UfFXabfDl

— NEJM (@NEJM) June 20, 2023