Pre-operative high-frequency ultrasound: a reliable management tool in auricular and nasal non-melanoma skin cancer.
skin cancer
skin imaging
surgery
systemic therapy
ultrasound
Journal
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
ISSN: 1610-0387
Titre abrégé: J Dtsch Dermatol Ges
Pays: Germany
ID NLM: 101164708
Informations de publication
Date de publication:
20 Jan 2024
20 Jan 2024
Historique:
received:
20
04
2023
accepted:
10
10
2023
medline:
20
1
2024
pubmed:
20
1
2024
entrez:
20
1
2024
Statut:
aheadofprint
Résumé
The knowledge of depth infiltration in non-melanoma skin cancer (NMSC) using pre-operative ultrasound could enable clinicians to choose the most adequate therapeutic approach, avoiding unnecessary surgeries and expensive imaging methods, delaying diagnosis and treatment. Our single-center retrospective study determined the usefulness of high-frequency ultrasound (HFUS) for depth infiltration assessment in auricular and nasal NMSC and assessed the subsequent change in therapeutic approach. In 60 NMSC cases, we assessed the accuracy of HFUS in cartilaginous/bone infiltration detection as well as the correlation of sonographic and histological parameters. In 16.6% of cases, a deep cartilaginous/bone involvement or locoregional disease was identified pre-operatively, resulting in a changed therapeutical scheme of radio-immunological treatment rather than surgery. In two cases, pre-operative HFUS identified local cartilage infiltration, reducing the number of surgical procedures. Forty-eight remaining lesions with no depth infiltration were excised; a correlation of > 99% between the histologic and sonographic tumor depth (p<0.001) was found. Pre-surgical HFUS influences the therapeutic management in NMSC by detecting subclinical involvement of deeper structures, avoiding more extensive diagnostics, reducing costs, and improving healthcare quality. High-frequency ultrasound should be implemented in dermatosurgery before tumor excision for optimized therapy and improved patient counseling.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
The knowledge of depth infiltration in non-melanoma skin cancer (NMSC) using pre-operative ultrasound could enable clinicians to choose the most adequate therapeutic approach, avoiding unnecessary surgeries and expensive imaging methods, delaying diagnosis and treatment. Our single-center retrospective study determined the usefulness of high-frequency ultrasound (HFUS) for depth infiltration assessment in auricular and nasal NMSC and assessed the subsequent change in therapeutic approach.
PATIENTS AND METHODS
METHODS
In 60 NMSC cases, we assessed the accuracy of HFUS in cartilaginous/bone infiltration detection as well as the correlation of sonographic and histological parameters.
RESULTS
RESULTS
In 16.6% of cases, a deep cartilaginous/bone involvement or locoregional disease was identified pre-operatively, resulting in a changed therapeutical scheme of radio-immunological treatment rather than surgery. In two cases, pre-operative HFUS identified local cartilage infiltration, reducing the number of surgical procedures. Forty-eight remaining lesions with no depth infiltration were excised; a correlation of > 99% between the histologic and sonographic tumor depth (p<0.001) was found.
CONCLUSIONS
CONCLUSIONS
Pre-surgical HFUS influences the therapeutic management in NMSC by detecting subclinical involvement of deeper structures, avoiding more extensive diagnostics, reducing costs, and improving healthcare quality. High-frequency ultrasound should be implemented in dermatosurgery before tumor excision for optimized therapy and improved patient counseling.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.
Références
Hu W, Fang L, Ni R, et al. Changing trends in the disease burden of non-melanoma skin cancer globally from 1990 to 2019 and its predicted level in 25 years. BMC Cancer. 2022;22(1):836.
Zambrano-Román M, Padilla-Gutiérrez JR, Valle Y, et al. Non-melanoma skin cancer: A genetic update and future perspectives. Cancers (Basel). 2022;14(10).
Stratigos AJ, Garbe C, Dessinioti C, et al. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. treatment. Eur J Cancer. 2020;128:83-102.
Kofler L, Ziemer M, Andrulis M, et al. S1-Guideline: Microscopically controlled surgery. J Dtsch Dermatol Ges. 2022;20(12):1663-1674.
Peris K, Fargnoli MC, Garbe C, et al. Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines. Eur J Cancer. 2019;118:10-34.
Kash N, Silapunt S. A review of emerging and non-US FDA-approved topical agents for the treatment of basal cell carcinoma. Future Oncol. 2021;17(23):3111-3132.
Migden MR, Rischin D, Schmults CD, et al. PD-1 Blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma. N Engl J Med. 2018;379(4):341-351.
Migden MR, Khushalani NI, Chang ALS, et al. Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial. Lancet Oncol. 2020;21(2):294-305.
Gambini D, Passoni E, Nazzaro G, et al. Basal cell carcinoma and hedgehog pathway inhibitors: Focus on immune response. Front Med (Lausanne). 2022;9:893063.
Cheraghi N, Cognetta A, Goldberg D. Radiation therapy in dermatology: Non-melanoma skin cancer. J Drugs Dermatol. 2017;16(5):464-469.
Spigariolo CB, Berti E, Brambilla R, Piccinno R. Radiation therapy of non-melanoma skin cancer of the pinna: an Italian 35-year experience. Ital J Dermatol Venerol. 2022;157(1):92-100.
Bard RL. High-frequency ultrasound examination in the diagnosis of skin cancer. Dermatol Clin. 2017;35(4):505-511.
Kim HJ, Lee SJ, Lee JH, et al. Usefulness of ultrasonography in determining the surgical excision margin in non-melanocytic skin cancer: A comparative analysis of preoperative ultrasonography and postoperative histopathology. Medicine (Baltimore). 2020;99(51):e23789.
Crisan D, Wortsman X, Alfageme F, et al. Ultrasonography in dermatologic surgery: revealing the unseen for improved surgical planning. J Dtsch Dermatol Ges. 2022;20(7):913-926.
Catalano O, Roldán FA, Varelli C, et al. Skin cancer: findings and role of high-resolution ultrasound. J Ultrasound. 2019;22(4):423-431.
Levy J, Barrett DL, Harris N, et al. High-frequency ultrasound in clinical dermatology: A review. Ultrasound J. 2021;13(1):24.
Wortsman X, Alfageme F, Roustan G, et al. Guidelines for performing dermatologic ultrasound examinations by the DERMUS Group. J Ultrasound Med. 2016;35(3):577-580.
Gaitini D, Ullmann Y, Javitt M. Ultrasound imaging: Basic principles and terminology. In: Wortsman X (editor). Textbook of dermatologic ultrasound: Springer, 2022:73-87.
Wortsman X. Technical Recommenations, Settings, Protocols, Training and Reports of the Dermatologic Ultrasound Examinations. In: Wortsman X (editor). Textbook of dermatologic ultrasound. Switzerland: Springer, 2022: 3-15.
Baba N, Kato H, Nakamura M, et al. Narrower clinical margin in high or very high-risk squamous cell carcinoma: a retrospective, multicenter study of 1,000 patients. J Dtsch Dermatol Ges. 2022;20(8):1088-1099.
Barcaui EO, Carvalho ACP, Valiante PM, et al. High-frequency (22-MHz) ultrasound for assessing the depth of basal cell carcinoma invasion. Skin Res Technol. 2021;27(5):676-681.
Crisan D, Kastler S, Scharffetter-Kochanek K, et al. Ultrasonographic assessment of depth infiltration in melanoma and non-melanoma skin cancer. J Ultrasound Med. 2023;42(7):1609-1616.
Alfageme F, Salgüero I, Nájera L, et al. Increased marginal stiffness differentiates infiltrative from noninfiltrative cutaneous basal cell carcinomas in the facial area: A prospective study. J Ultrasound Med. 2019;38(7):1841-1845.
Laverde-Saad A, Simard A, Nassim D, et al. Performance of ultrasound for identifying morphological characteristics and thickness of cutaneous basal cell carcinoma: A systematic review. Dermatology. 2022;238(4):692-710.
Crisan D, Vargas-Malvar AL, Kastler S, et al. Retrospective analysis of pre- and peri-operative morbidity of patients with non-melanoma skin cancer at a university skin cancer centre. Acta Derm Venereol. 2021;101(4):adv00440.
Rocha-Filho MAS, Studart-da-Fonseca-Filho MR, Studart-da-Fonseca MC, et al. Surgical resection of a cutaneous squamous cell carcinoma invading the infraorbital maxillary nerve. Interdisciplinary Neurosurgery. 2022;27:101385.
Kadakia S, Ducic Y, Marra D, et al. Cutaneous squamous cell carcinoma of the scalp in the immunocompromised patient: review of 53 cases. Oral Maxillofac Surg. 2016;20(2):171-175.
Kaya İ, Uslu M, Apaydın F. Defect reconstruction of the nose after surgery for nonmelanoma skin cancer: Our clinical experience. Turk Arch Otorhinolaryngol. 2017;55(3):111-118.
Blázquez-Sánchez N, Fernández-Canedo I, Repiso-Jiménez JB, et al. Usefulness of the paramedian forehead flap in nasal reconstructive surgery: A retrospective series of 41 patients. Actas Dermo-Sifiliográficas (English Edition). 2016;107(2):133-141.
Reich W, Exner A, Winter E, et al. Complex functional and epithetic rehabilitation after ablation of recurrent retroauricular basal cell carcinoma - a case study. GMS Interdiscip Plast Reconstr Surg DGPW. 2017;6:Doc18.
Crisan D, Schneider LA, Kastler S, et al. Surgical management of skin cancer and trauma involving the middle third of the auricle. J Dtsch Dermatol Ges. 2018;16(6):694-701.
Tang N, Ratner D. Implementation of systemic hedgehog inhibitors in daily practice as neoadjuvant therapy. J Natl Compr Canc Netw. 2017;15(4):537-543.
Curragh DS, Huilgol SC, Selva D. Neoadjuvant vismodegib in the management of locally advanced periocular basal cell carcinoma. Eye (Lond). 2021;35(10):2740-2745.
Kunstfeld R, Nguyen VA. New therapeutic developments for basal cell carcinoma. J Dtsch Dermatol Ges. 2023;21(4):382-385.
Persa OD, Mauch C. Complete excision of squamous cell carcinoma is superior to salvage radiotherapy for microscopic residual disease. J Dtsch Dermatol Ges. 2022;20(7):1020-1022.
Thompson AK, Kelley BF, Prokop LJ, et al. Risk Factors for cutaneous squamous cell carcinoma recurrence, metastasis, and disease-specific death: A systematic review and meta-analysis. JAMA Dermatol. 2016;152(4):419-428.
Heppt MV, Leiter U. Cutaneous squamous cell carcinoma: state of the art, perspectives and unmet needs. J Dtsch Dermatol Ges. 2023;21(4):421-424.
Ibrahim SF, Kasprzak JM, Hall MA, et al. Enhanced metastatic risk assessment in cutaneous squamous cell carcinoma with the 40-gene expression profile test. Future Oncol. 2022;18(7):833-847.
Sandby-Møller J, Thieden E, Philipsen PA, et al. Dermal echogenicity: a biological indicator of individual cumulative UVR exposure? Arch Dermatol Res. 2004;295(11):498-504.
Crisan M, Crisan D, Sannino G, et al. Ultrasonographic staging of cutaneous malignant tumors: an ultrasonographic depth index. Arch Dermatol Res. 2013;305(4):305-313.
Bobadilla F, Wortsman X, Muñoz C, et al. Pre-surgical high resolution ultrasound of facial basal cell carcinoma: correlation with histology. Cancer Imaging. 2008;8(1):163-172.
Seidl-Philipp M, Frischhut N, Höllweger N, et al. Known and new facts on basal cell carcinoma. J Dtsch Dermatol Ges. 2021;19(7):1021-1041.
Veness MJ. High-risk cutaneous squamous cell carcinoma of the head and neck. J Biomed Biotechnol. 2007;2007(3):80572.
Berritto D, Iacobellis F, Rossi C, et al. Ultra high-frequency ultrasound: New capabilities for nail anatomy exploration. J Dermatol. 2017;44(1):43-46.