Keratinocyte cancer with incidental perineural invasion: A registry analysis of management and 5-year outcomes.
Carcinoma, Basal Cell
/ pathology
Carcinoma, Squamous Cell
/ pathology
Head and Neck Neoplasms
/ pathology
Humans
Margins of Excision
Mohs Surgery
/ statistics & numerical data
Neoplasm Invasiveness
Neoplasm Recurrence, Local
/ pathology
Peripheral Nerves
/ pathology
Radiotherapy, Adjuvant
/ statistics & numerical data
Registries
Retrospective Studies
Skin Neoplasms
/ pathology
adjuvant radiotherapy
basal Cell Cancer
keratinocyte cancer
perineural invasion
squamous cell cancer
Journal
The Australasian journal of dermatology
ISSN: 1440-0960
Titre abrégé: Australas J Dermatol
Pays: Australia
ID NLM: 0135232
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
31
07
2019
revised:
20
02
2020
accepted:
14
03
2020
pubmed:
15
4
2020
medline:
6
7
2021
entrez:
15
4
2020
Statut:
ppublish
Résumé
Perineural invasion within keratinocyte cancer is a hallmark of tumour aggression, and a definitive treatment paradigm for this condition remains undetermined. Our aim was to investigate the treatment and outcomes of keratinocyte cancer with incidental perineural invasion within two skin cancer databases to refine treatment protocols. We retrospectively assessed the Queensland Perineural Invasion Registry for surgery, histopathology, adjuvant radiotherapy and recurrence of keratinocyte cancer five years post-definitive treatment. We also reviewed the Princess Alexandra Hospital Head and Neck clinical perineural invasion database, specifically looking at surgical margins and adjuvant radiotherapy of cutaneous squamous cell carcinoma (cSCC) with incidental perineural invasion in the primary lesion. There was no recurrence at 5 years in the Perineural Invasion Registry. Basal cell carcinoma (BCC) lesions with nerves <0.1 mm were more commonly treated with surgery alone, compared to lesions with nerves ≥0.1 mm which were offered adjuvant radiotherapy. Of the total BCC lesions with incidental perineural invasion, those with perineural margins ≥5 mm and peripheral tumour margins ≥3 mm were predominantly treated with surgery alone. Eighty-nine per cent of cSCC lesions with incidental perineural invasion were treated with surgery and adjuvant radiotherapy. Surgery alone is suitable for BCC lesions with incidental perineural invasion. The majority of BCC lesions achieved ≥5 mm perineural and ≥3 mm peripheral tumour margins. Future research can guide if adjuvant radiation is required for BCC with perineural invasion. The treatment of cSCC with incidental perineural invasion with surgery alone remains undetermined.
Sections du résumé
BACKGROUND/OBJECTIVES
OBJECTIVE
Perineural invasion within keratinocyte cancer is a hallmark of tumour aggression, and a definitive treatment paradigm for this condition remains undetermined. Our aim was to investigate the treatment and outcomes of keratinocyte cancer with incidental perineural invasion within two skin cancer databases to refine treatment protocols.
METHODS
METHODS
We retrospectively assessed the Queensland Perineural Invasion Registry for surgery, histopathology, adjuvant radiotherapy and recurrence of keratinocyte cancer five years post-definitive treatment. We also reviewed the Princess Alexandra Hospital Head and Neck clinical perineural invasion database, specifically looking at surgical margins and adjuvant radiotherapy of cutaneous squamous cell carcinoma (cSCC) with incidental perineural invasion in the primary lesion.
RESULTS
RESULTS
There was no recurrence at 5 years in the Perineural Invasion Registry. Basal cell carcinoma (BCC) lesions with nerves <0.1 mm were more commonly treated with surgery alone, compared to lesions with nerves ≥0.1 mm which were offered adjuvant radiotherapy. Of the total BCC lesions with incidental perineural invasion, those with perineural margins ≥5 mm and peripheral tumour margins ≥3 mm were predominantly treated with surgery alone. Eighty-nine per cent of cSCC lesions with incidental perineural invasion were treated with surgery and adjuvant radiotherapy.
CONCLUSION
CONCLUSIONS
Surgery alone is suitable for BCC lesions with incidental perineural invasion. The majority of BCC lesions achieved ≥5 mm perineural and ≥3 mm peripheral tumour margins. Future research can guide if adjuvant radiation is required for BCC with perineural invasion. The treatment of cSCC with incidental perineural invasion with surgery alone remains undetermined.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
226-230Informations de copyright
© 2020 The Australasian College of Dermatologists.
Références
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