Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Histological and clinical parameters correlating with high risk for metastasing of squamous cell carcinoma of the skin

J Wehner-Caroli, H Breuninger

Dept Dermatology, University of Tuebingen, Tuebingen, Germany,

Aim: The aim of the study was to determine histological and clinical parameters correlating with high risk for metastasizing of squamous cell carcinoma (SCC) of the skin. Materials & Methods: The course of disease was observed in 822 tumors and compared to clinical and histological features of the underlying SCC. Following data were recorded: immunosuppression, localization, entity, tumor thickness (Breslow), clinical size, depth of invasion (Clark), degree of differentiation (Broders). The course of disease was evaluated by computerized data based follow up investigations (Tumor Center Tuebingen). The mean lapse of observation was 4 years. The rate of metastasis (rm) over all carcinomas was 5,5% (45 tumors). Results: Our study shows that the following risk classes can be defined according to rates of metastasis: -immunosuppression: 32,1% (rm) versus no immunosuppression: 4,5%; -desmoplastic SCC: 23,2% vs. ‘common’ SCC: 4,2%; -degree of differentiation (Broders) G4: 20,3% vs. G1: 2,2%; -tumor thickness (Breslow) >5mm: 20,0% vs. 2-5mm: 5,4% and <2mm: 0%; -clinical size (mean of greatest diameter and the greatest diameter perpendicular on it) >20mm: 12,7% vs. ?20mm: 3,3%; -Clark level VI - VIII: 12,3% vs. Clark level I-V: 4,2%; -localization helix: 10,9% vs. lower lip: 7,2%, remaining head: 4,9%, trunk: 2,3%. Conclusion: The results show the importance of regular follow up investigations of squamous cell carcinomas of the skin with one or more clinical or histological criteria of high risk carcinomas as shown above.

KEY WORDS: squamous cell carcinoma, high risk, metastasis.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on metastasis & prevention.