Histological deep margins in cutaneous squamous cell carcinoma of the scalp and risk of recurrence
Por:
Verdaguer-Faja, J, Guerra-Amor, A, Ferrándiz-Pulido, C, Abril-Pérez, C, Estrada, RB, Masferrer, E, Lopez-Castillo, D, Deza, G, Leal, L, Marti-Marti, I, Ruiz-Salas, V, Yébenes, M, Martin, LM, Baliu, C, Castany, A, Boada, A, Toll, A and Jaka, A
Publicada:
1 abr 2025
Ahead of Print:
1 jul 2024
Resumen:
Background: Consensus is lacking on adequate deep histological margins in cutaneous squamous cell carcinoma (cSCC). Deep clearance for tumours located on the scalp is limited by anatomic constraints. Objective: To determine whether clear but close deep histological margins (<1 mm) confer a higher risk of recurrence in cSCCs of the scalp treated by wide local excision, compared to deep histological margins >= 1 mm. Methods: Multicentre retrospective observational cohort study and multivariate competing risk analysis to evaluate risk factors for recurrence. Results: In total, 295 patients with 338 cSCCs were included. Close deep histological margins were not associated with an increased cumulative incidence of recurrence (subhazard ratio [SHR] 1.96 [95% CI 0.87-4.41]). However, an increased risk of recurrence was observed for those tumours that presented concurrent invasion of the galea aponeurotica and close deep margins, as opposed to patients without these factors (SHR 3.52 [1.24-10.01]). Tumours with clear but close peripheral margins (<1 mm) also had higher risk of recurrence (SHR 5.01 [1.68-14.97]). Limitations: Retrospective observational study based on pathology reports. Conclusion: Deep histological margins <1 mm do not confer a greater risk of recurrence as long as the tumour is completely excised and the galea aponeurotica is not involved. Surgical excision of cSCC on the scalp should include the galea to ensure proper assessment of deep margins.
Filiaciones:
Verdaguer-Faja, J:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Dermatol, Carretera Canyet S-N, Badalona 08916, Barcelona, Spain
Guerra-Amor, A:
Hosp Univ Vall dHebron, Dept Dermatol, Barcelona, Spain
Ferrándiz-Pulido, C:
Hosp Badalona Germans Trias & Pujol, Dept Dermatol, Carretera Canyet S-N, Badalona 08916, Barcelona, Spain
Hosp Univ Vall dHebron, Dept Dermatol, Barcelona, Spain
Abril-Pérez, C:
Hosp Univ La Fe, Dept Dermatol, Inst Invest Sanitaria La Fe ISS La Fe, Valencia, Spain
Estrada, RB:
Hosp Univ La Fe, Dept Dermatol, Inst Invest Sanitaria La Fe ISS La Fe, Valencia, Spain
Univ Valencia, Valencia, Spain
Masferrer, E:
Hosp Univ Mutua Terrassa, Dept Dermatol, Terrassa, Spain
Lopez-Castillo, D:
Hosp Univ Mutua Terrassa, Dept Dermatol, Terrassa, Spain
Deza, G:
Hosp del Mar, Inst Mar Invest Med, Dept Dermatol, Barcelona, Spain
Leal, L:
Hosp del Mar, Inst Mar Invest Med, Dept Dermatol, Barcelona, Spain
Marti-Marti, I:
Univ Barcelona, Hosp Clin Barcelona, Dept Dermatol, Barcelona, Spain
Ruiz-Salas, V:
Hosp Santa Creu & Sant Pau, Dept Dermatol, Barcelona, Spain
Yébenes, M:
Hosp Parc Tauli, Dept Dermatol, Sabadell, Spain
Martin, LM:
Hosp Santa Caterina, Dept Dermatol, Girona, Spain
Baliu, C:
Hosp Univ Igualada, Dept Dermatol, Igualada, Spain
Castany, A:
Hosp Univ Igualada, Dept Dermatol, Igualada, Spain
:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Dermatol, Carretera Canyet S-N, Badalona 08916, Barcelona, Spain
Toll, A:
Univ Barcelona, Hosp Clin Barcelona, Dept Dermatol, Barcelona, Spain
:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Dermatol, Carretera Canyet S-N, Badalona 08916, Barcelona, Spain
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