Journal of the American Academy of Dermatology · 2025
Satellitosis or in-transit metastasis in cutaneous squamous cell carcinoma: Risk factors and the prognostic significance.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Pahalyants Vartan, Jairath Neil K, Maas Derek E, Cheraghlou Shayan, Mandal Soutrik, Friedman Steven, Criscito Maressa C, Lee Nayoung, Doudican Nicole A, Ruiz Emily S, Ran Nina, Granger Emily E, Koyfman Shlomo, Vidimos Alison, Wysong Ashley, Carr David R, Shahwan Kathryn T, Hirotsu Kelsey E, Carter Joi B, Cañueto Javier, Girardi Fabio Muradás, Mangold Aaron R, Srivastava Divya, Brodland David G, Zitelli John A, Willenbrink Tyler J, Carucci John A
Аннотация
BACKGROUND: Satellitosis or in-transit metastasis (S-ITM) from cutaneous squamous cell carcinoma (cSCC) is associated with poor outcomes but is not included in current staging guidelines.
OBJECTIVE: To determine risk factors and prognostic significance of S-ITM.
METHODS: This cohort study included 8901 patients with cSCC from 12 institutions (1998-2023). Risk factors for S-ITM were calculated using logistic regression. Outcomes were compared with 1:2 propensity score matched controls using a Fine-Gray subdistribution hazard model.
RESULTS: Seventy-seven patients developed S-ITM. Increased patient age (odds ratio [OR], 1.03; 95% CI, 1.01-1.05; P < .01), history of immunosuppression (OR, 4.31; 95% CI, 2.59-7.10; P < .001), higher Brigham and Women's Hospital stage (T2a OR, 4.14; 95% CI, 2.05-8.41; T2b OR, 15.96; 95% CI, 8.58-31.19; and T3 OR, 30.27; 95% CI, 10.70-79.04; all P < .001), and lymphovascular invasion (OR, 4.57; 95% CI, 1.80-10.38; P = .001) were independent risk factors for S-ITM. S-ITM was associated with local recurrence (subhazard ratio [SHR], 2.40; 95% CI, 1.43-4.04; P < .001), nodal metastasis (SHR, 1.89; 95% CI, 0.02-3.49; P = .04), distant metastasis (SHR, 4.41; 95% CI, 1.45-13.27; P = .01), and disease-specific death (SHR, 4.48; 95% CI, 2.34-8.58; P < .001).
LIMITATIONS: Retrospective cohort study. The rarity of S-ITM may limit statistical power.
CONCLUSION: Patients with cSCC and S-ITM are at higher risk for poor outcomes independent of patient, tumor, and treatment characteristics.
OBJECTIVE: To determine risk factors and prognostic significance of S-ITM.
METHODS: This cohort study included 8901 patients with cSCC from 12 institutions (1998-2023). Risk factors for S-ITM were calculated using logistic regression. Outcomes were compared with 1:2 propensity score matched controls using a Fine-Gray subdistribution hazard model.
RESULTS: Seventy-seven patients developed S-ITM. Increased patient age (odds ratio [OR], 1.03; 95% CI, 1.01-1.05; P < .01), history of immunosuppression (OR, 4.31; 95% CI, 2.59-7.10; P < .001), higher Brigham and Women's Hospital stage (T2a OR, 4.14; 95% CI, 2.05-8.41; T2b OR, 15.96; 95% CI, 8.58-31.19; and T3 OR, 30.27; 95% CI, 10.70-79.04; all P < .001), and lymphovascular invasion (OR, 4.57; 95% CI, 1.80-10.38; P = .001) were independent risk factors for S-ITM. S-ITM was associated with local recurrence (subhazard ratio [SHR], 2.40; 95% CI, 1.43-4.04; P < .001), nodal metastasis (SHR, 1.89; 95% CI, 0.02-3.49; P = .04), distant metastasis (SHR, 4.41; 95% CI, 1.45-13.27; P = .01), and disease-specific death (SHR, 4.48; 95% CI, 2.34-8.58; P < .001).
LIMITATIONS: Retrospective cohort study. The rarity of S-ITM may limit statistical power.
CONCLUSION: Patients with cSCC and S-ITM are at higher risk for poor outcomes independent of patient, tumor, and treatment characteristics.