TY - JOUR
T1 - In-transit metastasis from squamous cell carcinoma
AU - Ma, Joyce H. Y.
AU - Wu, Albert
AU - Veness, Michael
AU - Estall, Vanessa
AU - Hong, Angela
AU - Borg, Martin
AU - James, Craig
AU - Ibbetson, Jan
AU - Ooi, Colin
AU - Weightman, Warren
AU - McColl, Ian
AU - Hamann, Ian
AU - Grieve, Noel
AU - Ozluer, Selim
AU - Salmon, Paul
AU - Nikitins, Markus
AU - Caplash, Yugesh
AU - Marshall, Nicholas
AU - Edwards, Timothy
AU - Patterson, Ian
AU - Selva, Dinesh
AU - Huilgol, Shyamala C.
PY - 2016
Y1 - 2016
N2 - BACKGROUND In-transit metastasis from cutaneous squamous cell carcinoma (SCC) is an uncommon form of metastasis through lymphatics and occurs more commonly in immunosuppressed patients. OBJECTIVE To identify cases of in-transit SCC and determine patient characteristics, tumor features, management, and prognosis. METHODS AND MATERIALS A multicenter case series treated by Australian and New Zealand clinicians. RESULTS In 31 patients, median age was 72 years (range 52-99) and 68% were immunocompetent. Tumors occurred on the head and neck in 94% of cases, with 71% of all tumors occurring on the scalp, forehead, or temple. The median time to presentation with in-transit SCC from treatment of the initial tumor was 5 months. Management included surgery (94%), radiotherapy (77%), chemotherapy (10%), and reduction of immunosuppression (3%). Median follow-up was 12 months. Overall survival at 3 and 5 years were 27% and 13%, respectively. CONCLUSION In-transit metastases are described in 31 patients, of whom the majority was immunocompetent. The scalp, forehead, and temple were the most common sites. New clinical and histological diagnostic criteria are proposed. Prognosis was poor with 5-year survival of 13%. Recommended management is a combination of surgery and adjuvant radiotherapy. Reduction of any iatrogenic immunosuppression should be considered. © 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc.
AB - BACKGROUND In-transit metastasis from cutaneous squamous cell carcinoma (SCC) is an uncommon form of metastasis through lymphatics and occurs more commonly in immunosuppressed patients. OBJECTIVE To identify cases of in-transit SCC and determine patient characteristics, tumor features, management, and prognosis. METHODS AND MATERIALS A multicenter case series treated by Australian and New Zealand clinicians. RESULTS In 31 patients, median age was 72 years (range 52-99) and 68% were immunocompetent. Tumors occurred on the head and neck in 94% of cases, with 71% of all tumors occurring on the scalp, forehead, or temple. The median time to presentation with in-transit SCC from treatment of the initial tumor was 5 months. Management included surgery (94%), radiotherapy (77%), chemotherapy (10%), and reduction of immunosuppression (3%). Median follow-up was 12 months. Overall survival at 3 and 5 years were 27% and 13%, respectively. CONCLUSION In-transit metastases are described in 31 patients, of whom the majority was immunocompetent. The scalp, forehead, and temple were the most common sites. New clinical and histological diagnostic criteria are proposed. Prognosis was poor with 5-year survival of 13%. Recommended management is a combination of surgery and adjuvant radiotherapy. Reduction of any iatrogenic immunosuppression should be considered. © 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc.
UR - https://hdl.handle.net/1959.7/uws:64385
U2 - 10.1097/DSS.0000000000000864
DO - 10.1097/DSS.0000000000000864
M3 - Article
SN - 1076-0512
VL - 42
SP - 1285
EP - 1292
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 11
ER -
