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

Publication date: February 2017
Source:Journal of the American Academy of Dermatology, Volume 76, Issue 2
Author(s): Emily Stamell Ruiz, Pritesh S. Karia, Frederick C. Morgan, Chrysalyne D. Schmults
BackgroundThere 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.



http://ift.tt/2j7ZlLY