AI Article Synopsis
- Cutaneous squamous cell carcinoma (cSCC) usually has a good prognosis, but some cases progress aggressively, with lymphovascular invasion (LVI) being a significant, yet under-researched, factor in these outcomes.
- A study analyzed 486 cSCC cases over five years, finding LVI in 9.2% of patients, and its presence correlated with deeper tumors, specific locations, and larger sizes.
- Patients with LVI showed significantly lower overall survival rates at 2 years (37.1% vs. 66.6%), indicating that LVI is an important independent marker of poor prognosis and should be included in future risk assessment systems for cSCC.
Article Abstract
Background: The majority of cutaneous squamous cell carcinomas (cSCC) have a favourable prognosis. However, a subset of cases follow an aggressive disease course with progression to metastasis and death. Several histopathological parameters are associated with poor outcomes, but lymphovascular invasion (LVI) has not been well studied.
Objective: To assess the prognostic significance of LVI in cSCC and determine associations between LVI and cSCC.
Methods: A retrospective review of 486 consecutive cases of cSCC over a 5-year period from a single centre was stratified by the presence or absence of LVI. Logistic regression and multivariate survival analysis were used to determine associations of LVI and prognostic significance of LVI, respectively.
Findings: LVI was present in 41 cases (9.2%). LVI was significantly associated with increasing depth of invasion, microanatomical tumour location (subcutis vs. dermis), and tumour dimensions (P < 0.05). Univariate survival analysis revealed significantly lower 2-year overall survival rates for patients with LVI (37.1%) compared with those without (66.6%) (95% CI = 60.6-73.3, P < 0.001). LVI was also found to be an independent marker of poor disease-specific survival (HR = 0.232 (95% CI = 0.090-0.600), P = 0.003), poor overall survival (HR 0.338 (95% CI = 0.184-0.623), P < 0.001) and poor disease-free survival (HR 0.461 (95% CI = 0.230-0.923), P = 0.029) through multivariate analysis.
Conclusions: This study confirms that LVI is an independent poor prognosticator in cSCC, with significantly worse survival indices at 2 years. Future systems of risk stratification for cSCC should incorporate LVI.
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| http://dx.doi.org/10.1111/ans.18694 | DOI Listing |
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