The positive impact of radiologic imaging on high-stage cutaneous squamous cell carcinoma management

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• 作者：Emily Stamell Ruiz ; MD ; Pritesh S. Karia ; MPH ; Frederick C. Morgan ; BSPH ; Chrysalyne D. Schmults ; MD ; MSCE ; ^{cschmults@partners.org}
• 关键词：cutaneous squamous cell carcinoma ; staging ; prognosis ; radiologic imaging ; disease-related outcomes ; nodal metastasis ; squamous cell carcinoma imaging
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：76
• 期：2
• 页码：217-225
• 全文大小：235 K
• 卷排序：76

文摘

There is limited evidence on the utility of radiologic imaging for prognostic staging of cutaneous squamous cell carcinoma (CSCC).ObjectiveReview utilization of radiologic imaging of high-stage CSCCs to evaluate whether imaging impacted management and outcomes.MethodsTumors classified as Brigham and Women's Hospital (BWH) tumor (T) stage T2B or T3 over a 13-year period were reviewed to identify whether imaging was performed and whether results affected treatment. Disease-related outcomes (DRO: local recurrence, nodal metastasis, death from disease) were compared between patients by type of imaging used.Results108 high-stage CSCCs in 98 patients were included. Imaging (mostly computed tomography, 79%) was utilized in 45 (46%) patients and management was altered in 16 (33%) patients who underwent imaging. Patients that received no imaging were at higher risk of developing nodal metastases (nonimaging, 30%; imaging, 13%; P = .041) and any DRO (nonimaging, 42%; imaging, 20%; P = .028) compared to the imaging group. Imaging was associated with a lower risk for DRO (subhazard ratio, 0.5; 95% CI 0.2-0.9; P = .046) adjusted for BWH T stage, sex, and location.LimitationsSingle institution retrospective design and changes in technology overtime.ConclusionsRadiologic imaging of high-stage CSCC may influence management and appears to positively impact outcomes. Further prospective studies are needed to establish which patients benefit from imaging.